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General NPI Number Information
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NPI Number | 1053644047
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Entity Type | Individual
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Provider Name | MELISSA JON NOEL PSYD, CACII
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Gender | Female
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Dates
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Enumeration Date | 09/09/2009
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Last Update Date | 09/09/2019
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Provider Practice Location Address
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Address Line | 4900 E CHERRY CREEK SOUTH DR
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City | DENVER
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State | CO
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Zip | 80246-2283
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Country | US
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Telephone | 303-345-7611
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Fax |
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Provider Business Mailing Address
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Address Line | 1241 S RACE ST
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City | DENVER
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State | CO
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Zip | 80210-1817
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Country | US
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Telephone | 303-345-7611
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSYC.00014089
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACB.0007055
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License Number State | CO
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