MEDICARE: MELISSA STELLINI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6801105377	MI

General Provider Information

NPI Number	:	1063020873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA STELLINI

Provider Business Mailing Address
First Line	:	26901 BEAUMONT BLVD STE 3D
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-3849
Country	:	US
Telephone Number	:	947-522-1863
Fax Number	:

Provider Business Practice Location Address
First Line	:	25912 ANNAPOLIS ST
Second Line	:
City	:	INKSTER
State	:	MI
Zip	:	48141-3201
Country	:	US
Telephone Number	:	313-565-2174
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2020
Last Update Date	:	07/17/2020

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Directions to “ MELISSA STELLINI ” Practice Location

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