Healthcare Provider Details

I. General information

NPI: 1588135578
Provider Name (Legal Business Name): MELANIE SALSBURY CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2018
Last Update Date: 12/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4835 POPLAR LEVEL RD
LOUISVILLE KY
40213-2905
US

IV. Provider business mailing address

4811 CLIPPING CT
LOUISVILLE KY
40241-1001
US

V. Phone/Fax

Practice location:
  • Phone: 855-591-0092
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6862
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: