Provider Demographics
NPI:1679370878
Name:BLAIR, MELANIE (LPC)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:BLAIR
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-1832
Mailing Address - Country:US
Mailing Address - Phone:908-514-8590
Mailing Address - Fax:908-889-5619
Practice Address - Street 1:61 PEARL ST
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-1832
Practice Address - Country:US
Practice Address - Phone:908-514-8590
Practice Address - Fax:908-889-5619
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC01080400101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor