MEDICARE: MELANIE REUSS MS, LPCC, LMFT, NCC

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	390200000X	Student in an Organized Health Care Education/Training Program	01945	MN
2	106H00000X	Marriage & Family Therapist	3641	MN

General Provider Information

NPI Number	:	1063951226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE REUSS MS, LPCC, LMFT, NCC

Provider Business Mailing Address
First Line	:	14525 HIGHWAY 7 STE 225
Second Line	:
City	:	MINNETONKA
State	:	MN
Zip	:	55345-3734
Country	:	US
Telephone Number	:	763-577-2489
Fax Number	:	952-443-4604

Provider Business Practice Location Address
First Line	:	14525 HIGHWAY 7 STE 225
Second Line	:
City	:	MINNETONKA
State	:	MN
Zip	:	55345-3734
Country	:	US
Telephone Number	:	763-577-2489
Fax Number	:

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

Provider Enumeration Date	:	02/20/2017
Last Update Date	:	09/04/2019

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