Healthcare Provider Details

I. General information

NPI: 1649427709
Provider Name (Legal Business Name): MELISSA S BURR-BARTOLO LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2008
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40060 NATIONAL RD
BETHESDA OH
43719-9763
US

IV. Provider business mailing address

2000 NOBLE DR
WOOSTER OH
44691-5353
US

V. Phone/Fax

Practice location:
  • Phone: 740-782-0092
  • Fax:
Mailing address:
  • Phone: 330-264-3232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1000066-SUPV
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberDP00944901
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: