Healthcare Provider Details

I. General information

NPI: 1700282746
Provider Name (Legal Business Name): MELISSA CARPENTER MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA NEWLAND

II. Dates (important events)

Enumeration Date: 11/18/2014
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

S5300 WI-37
EAU CLAIRE WI
54701
US

IV. Provider business mailing address

S5300 WI-37
EAU CLAIRE WI
54701
US

V. Phone/Fax

Practice location:
  • Phone: 715-835-4530
  • Fax:
Mailing address:
  • Phone: 715-835-4530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12233125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: