Healthcare Provider Details

I. General information

NPI: 1902248032
Provider Name (Legal Business Name): MELISSA ANN SLUITER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2013
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 N SAINT JOSEPH AVE STE 101
NILES MI
49120-2203
US

IV. Provider business mailing address

42 N SAINT JOSEPH AVE STE 101
NILES MI
49120-2203
US

V. Phone/Fax

Practice location:
  • Phone: 269-687-4673
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801067758
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: