=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417622259
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MELODIE A MARTINI LMHC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/13/2021
-----------------------------------------------------
Last Update Date | 12/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 124 STATE ROAD 46 W
-----------------------------------------------------
City | BATESVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47006-1487
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-933-6000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4778 S FARMERS RETREAT RD
-----------------------------------------------------
City | DILLSBORO
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47018-9025
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-571-0121
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 39004316A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | 39004316A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------