Individual
MR. CHARLES L MELLINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LICSW
Contact information
Practice address
23 BROADWAY, BEVERLY, MA 01915-4417
(978) 922-2280
(978) 927-1758
Mailing address
18 HATHAWAY AVE, BEVERLY, MA 01915-1416
(978) 922-2280
(978) 927-1758
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
21135
MA
Other
Enumeration date
10/31/2006
Last updated
07/08/2007
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