Healthcare Provider Details

I. General information

NPI: 1356180467
Provider Name (Legal Business Name): MELANIE HEUER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELANIE BADYNA

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3453 HUBBARD ST
HAMILTON MI
49419-9501
US

IV. Provider business mailing address

3453 HUBBARD ST
HAMILTON MI
49419-9501
US

V. Phone/Fax

Practice location:
  • Phone: 810-623-5413
  • Fax:
Mailing address:
  • Phone: 810-623-5413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401224293
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: