Healthcare Provider Details

I. General information

NPI: 1336367549
Provider Name (Legal Business Name): MELISSA LYNNE DUBOISE M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA ALLTOP LPCC

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S MAIN ST
BELLEFONTAINE OH
43311-1508
US

IV. Provider business mailing address

227 BRADLEY ST
WEST LIBERTY OH
43357-9502
US

V. Phone/Fax

Practice location:
  • Phone: 937-599-2766
  • Fax: 937-599-3151
Mailing address:
  • Phone: 937-465-4535
  • Fax: 937-599-3151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.0700136-SUPV
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: