Provider Demographics
NPI:1053572180
Name:BRECHER, MELINDA ANNE (LICSW)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:ANNE
Last Name:BRECHER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 POND AVE
Mailing Address - Street 2:APT. B420
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7163
Mailing Address - Country:US
Mailing Address - Phone:617-879-1781
Mailing Address - Fax:
Practice Address - Street 1:789 CLAPBOARDTREE ST
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-1717
Practice Address - Country:US
Practice Address - Phone:781-762-4001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1140671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical