Melillo, Anthony Mark

Melillo, Anthony Mark is an sole proprietor health care provider with primary practice located at 504 Main St , Bennington VT 05201-2111. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Melillo, Anthony Mark can be contacted via phone (413) 446-4210.

Contact Information

Primary practice address
504 Main St Bennington VT 05201-2111
Phone: (413) 446-4210
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 089-0001010 Vermont
Behavioral Health & Social Service Providers / Clinical 1041C0700X 1024625 Massachusetts
Behavioral Health & Social Service Providers / Clinical 1041C0700X 04-PE-AOOOAJ9 Wisconsin

Profile Details

NPI number 1225167984
LBN Legal business name Melillo, Anthony Mark
Credentials MSW,LICSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 5th, 2007
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225167984 NPPES
Vermont MEDICAID 1011283
Vermont Other CBH1057539

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