Healthcare Provider Details

I. General information

NPI: 1609790005
Provider Name (Legal Business Name): HANNAH MELICK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 JOHN F KENNEDY PKWY STE 200
FORT COLLINS CO
80525-2635
US

IV. Provider business mailing address

3500 JOHN F KENNEDY PKWY STE 200
FORT COLLINS CO
80525-2635
US

V. Phone/Fax

Practice location:
  • Phone: 970-889-8204
  • Fax: 888-494-3756
Mailing address:
  • Phone: 970-889-8204
  • Fax: 888-494-3756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSYC.00016374
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: