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NPI Code Detail

MEDICARE: MELISSA MCHENRY LCPC

MEDICARE: MELISSA MCHENRY LCPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorIL

General Provider Information

NPI Number : 1225185887
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA MCHENRY LCPC
Provider Business Mailing Address
First Line : 114 WHITELAW AVENUE
Second Line :
City : WOOD RIVER
State : IL
Zip : 62095
Country : US
Telephone Number : 618-251-4225
Fax Number : 618-251-4586
Provider Business Practice Location Address
First Line : 114 WHITELAW AVE
Second Line :
City : WOOD RIVER
State : IL
Zip : 62095-1911
Country : US
Telephone Number : 618-251-4225
Fax Number : 618-251-4586
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2007
Last Update Date : 07/08/2007

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Directions to “ MELISSA MCHENRY LCPC” Practice Location

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