Healthcare Provider Details

I. General information

NPI: 1871564542
Provider Name (Legal Business Name): MELANIE MARIA SMITH LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16020 SWINGLEY RIDGE RD STE 300
CHESTERFIELD MO
63017-2085
US

IV. Provider business mailing address

4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7630
US

V. Phone/Fax

Practice location:
  • Phone: 636-681-2620
  • Fax: 636-933-3510
Mailing address:
  • Phone: 636-681-2620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2001031173
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: