# MELINA MANSOUR LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629493036
- **Authorized official:** MELINA MANSOUR LMFT (OWNER/LMFT)
- **Authorized official phone:** (860) 378-9605

## Contact information

- **Practice address:** 51 N MAIN ST, SUITE 2D, SOUTHINGTON, CT 06489-2537
- **Practice address phone:** (860) 378-9605
- **Practice address fax:** (860) 328-3966
- **Mailing address:** 1175 S MAIN ST, UNIT 1, PLANTSVILLE, CT 06479-1690
- **Mailing address phone:** (860) 378-9605
- **Mailing address fax:** (860) 628-3966

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 000462 | CT | Yes |

## Other

- **Enumeration date:** 02/20/2014
- **Last updated:** 02/20/2014