Healthcare Provider Details

I. General information

NPI: 1346780780
Provider Name (Legal Business Name): MELISSA MYERS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2017
Last Update Date: 03/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 ADA RD
LIMA OH
45801-3342
US

IV. Provider business mailing address

8135 MOUNT VERNON RD
SAINT LOUISVILLE OH
43071-9670
US

V. Phone/Fax

Practice location:
  • Phone: 419-221-1226
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.1300528
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: