Healthcare Provider Details

I. General information

NPI: 1548509573
Provider Name (Legal Business Name): MELISSA MADDEN SCHLEGEL MA, RMHCI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISSY MADDEN-SCHLEGEL MA, RMHCI

II. Dates (important events)

Enumeration Date: 02/12/2013
Last Update Date: 11/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1009 MAITLAND CENTER COMMONS BLVD SUITE 212
MAITLAND FL
32751-7270
US

IV. Provider business mailing address

1009 MAITLAND CENTER COMMONS BLVD SUITE 212
MAITLAND FL
32751-7270
US

V. Phone/Fax

Practice location:
  • Phone: 407-636-3532
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH8344
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: