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General NPI Number Information
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NPI Number | 1518504810
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Entity Type | Individual
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Provider Name | MELISSA ANN ROUSH LPC
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Gender | Female
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Dates
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Enumeration Date | 12/05/2019
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Last Update Date | 09/27/2021
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Provider Practice Location Address
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Address Line | 2305 S. CUSTER #1305
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City | MCKINNEY
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State | TX
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Zip | 75072
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Country | US
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Telephone | 469-667-6050
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Fax |
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Provider Business Mailing Address
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Address Line | 2305 S. CUSTER #1305
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City | MCKINNEY
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State | TX
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Zip | 75072
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Country | US
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Telephone | 469-667-6050
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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 | 72553
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 72553
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License Number State | TX
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