Healthcare Provider Details

I. General information

NPI: 1417622259
Provider Name (Legal Business Name): MELODIE A MARTINI LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2021
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 STATE ROAD 46 W
BATESVILLE IN
47006-1487
US

IV. Provider business mailing address

4778 S FARMERS RETREAT RD
DILLSBORO IN
47018-9025
US

V. Phone/Fax

Practice location:
  • Phone: 812-933-6000
  • Fax:
Mailing address:
  • Phone: 812-571-0121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39004316A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number39004316A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: