=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619852282
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MELISSA SEXTON PMHNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/11/2025
-----------------------------------------------------
Last Update Date | 08/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3090 W MARKET ST STE 119
-----------------------------------------------------
City | FAIRLAWN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44333-3615
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-234-8746
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4354 W 229TH ST
-----------------------------------------------------
City | FAIRVIEW PARK
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44126-1837
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-596-8481
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | APRN.CNP.0039532
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------