# MR. ANTHONY MARK MELILLO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1225167984
- **Gender:** Man
- **Credential:** MSW,LICSW

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 04-PE-AOOOAJ9 | WI | — |
| 1041C0700X | Clinical Social Worker | 089-0001010 | VT | Yes |
| 1041C0700X | Clinical Social Worker | 1024625 | MA | — |

## Other

- **Enumeration date:** 03/05/2007
- **Last updated:** 07/09/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1011283 | — | VT |
| 01 | — | CBH1057539 | CIGNA BEHAVIORAL HEALTH | VT |