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General NPI Number Information
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NPI Number | 1285125476
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Entity Type | Individual
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Provider Name | SARAH ANITA MELTON
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Gender | Female
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Dates
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Enumeration Date | 05/23/2018
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 6809 122ND AVE
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City | KENOSHA
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State | WI
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Zip | 53142-7335
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Country | US
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Telephone | 262-891-6575
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Fax | 262-654-5467
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Provider Business Mailing Address
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Address Line | 6809 122ND AVE
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City | KENOSHA
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State | WI
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Zip | 53142-7335
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Country | US
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Telephone | 262-891-6575
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Fax | 262-654-5467
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 11845-124
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34511
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW135712
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.025054
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC06064400
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License Number State | NJ
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