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General NPI Number Information
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NPI Number | 1649528399
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Entity Type | Individual
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Provider Name | MELISSA WHEELER LISW
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Gender | Female
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Dates
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Enumeration Date | 08/28/2012
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 20545 DETROIT RD # 8
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City | ROCKY RIVER
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State | OH
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Zip | 44116-2426
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Country | US
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Telephone | 216-600-8488
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Fax |
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Provider Business Mailing Address
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Address Line | 6773 ORCHARD BLVD
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City | PARMA HEIGHTS
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State | OH
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Zip | 44130
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Country | US
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Telephone | 440-787-9819
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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 | I1200478
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License Number State | OH
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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 | I.1200478
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License Number State | OH
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