Healthcare Provider Details

I. General information

NPI: 1821934019
Provider Name (Legal Business Name): MELANIE L ALLEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 INDIAN HILLS DR BLDG C
SIOUX CITY IA
51104-1859
US

IV. Provider business mailing address

2201 FAIRBANKS ST
SIOUX CITY IA
51109-1115
US

V. Phone/Fax

Practice location:
  • Phone: 712-293-4900
  • Fax:
Mailing address:
  • Phone: 402-802-8749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number138421
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: