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NPI Code Detail

MEDICARE: JANEL MELINKOVICH REESE LCSW

MEDICARE: JANEL MELINKOVICH REESE LCSW
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
11041C0700XClinical Social WorkerLCSW-933WY

General Provider Information

NPI Number : 1811276215
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANEL MELINKOVICH REESE LCSW
Provider Business Mailing Address
First Line : PO BOX 1842
Second Line :
City : CHEYENNE
State : WY
Zip : 82003-1842
Country : US
Telephone Number : 503-720-8648
Fax Number :
Provider Business Practice Location Address
First Line : 623 W 20TH ST
Second Line :
City : CHEYENNE
State : WY
Zip : 82001-3501
Country : US
Telephone Number : 307-222-9651
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2011
Last Update Date : 07/10/2023

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