Healthcare Provider Details

I. General information

NPI: 1952265621
Provider Name (Legal Business Name): MELLIN COUNSELING AND CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 CHIPPEWA SQ STE 12
MARQUETTE MI
49855-4814
US

IV. Provider business mailing address

708 CHIPPEWA SQ STE 12
MARQUETTE MI
49855-4814
US

V. Phone/Fax

Practice location:
  • Phone: 906-401-1371
  • Fax:
Mailing address:
  • Phone: 906-401-1371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MARY BETH MELLIN
Title or Position: CLINICIAN
Credential:
Phone: 906-250-1938