Healthcare Provider Details

I. General information

NPI: 1649781238
Provider Name (Legal Business Name): MELANEE ANDERSON CPST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2017
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13201 GRANGER RD
GARFIELD HTS OH
44125-1978
US

IV. Provider business mailing address

13201 GRANGER RD
GARFIELD HEIGHTS OH
44125-1978
US

V. Phone/Fax

Practice location:
  • Phone: 216-831-2255
  • Fax:
Mailing address:
  • Phone: 216-831-2255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2504079-TRNE
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.2513147
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: