Healthcare Provider Details

I. General information

NPI: 1790205656
Provider Name (Legal Business Name): MELISSA L WILLIAMS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA L HILDEBRANDT

II. Dates (important events)

Enumeration Date: 06/22/2017
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 BLUE RIDGE BLVD
RAYTOWN MO
64133-5629
US

IV. Provider business mailing address

1555 NE RICE RD
LEES SUMMIT MO
64086-5849
US

V. Phone/Fax

Practice location:
  • Phone: 816-966-0900
  • Fax: 816-347-3029
Mailing address:
  • Phone: 816-966-0900
  • Fax: 816-347-3069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2015026782
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: