| Mellem Clinic | |
|
145 Waterman St Providence RI 02906-2128 | |
| (347) 674-1136 | |
| Not Available |
| Full Name | Mellem Clinic |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 145 Waterman St, Providence, Rhode Island |
| Authorized Official Name and Position | Inga Korsgaard (OWNER, CLINICAL DIRECTOR) |
| Authorized Official Contact | 3476741136 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mellem Clinic 30 John St Providence RI 02906-1043 Ph: (347) 549-0280 | Mellem Clinic 145 Waterman St Providence RI 02906-2128 Ph: (347) 674-1136 |
| NPI Number | 1881472710 |
|---|---|
| Provider Enumeration Date | 09/21/2023 |
| Last Update Date | 03/25/2024 |
| Certification Date | 03/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881472710 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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