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NPI Code Detail

MEDICARE: MS. MELISSA ANN BLANKENSHIP LCPC

MEDICARE:  MS. MELISSA ANN BLANKENSHIP  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
1101YP2500XProfessional Counselor180.017074IL

General Provider Information

NPI Number : 1649919739
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MELISSA ANN BLANKENSHIP LCPC
Provider Business Mailing Address
First Line : 3359 SMYTHBERRY LN APT 2
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62711-8212
Country : US
Telephone Number : 217-622-5768
Fax Number :
Provider Business Practice Location Address
First Line : 2200 S 6TH ST
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62703-3454
Country : US
Telephone Number : 217-698-7150
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2022
Last Update Date : 04/23/2026

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Directions to “ MS. MELISSA ANN BLANKENSHIP LCPC” Practice Location

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