MEDICARE: ROBIN MELVILLE

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	101YP2500X	Professional Counselor	5602	MN

General Provider Information

NPI Number	:	1568390326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN MELVILLE

Provider Business Mailing Address
First Line	:	4930 VALLEY FORGE LN N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55442-3023
Country	:	US
Telephone Number	:	507-271-4028
Fax Number	:

Provider Business Practice Location Address
First Line	:	9531 W 78TH ST STE 220
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-3863
Country	:	US
Telephone Number	:	952-395-3290
Fax Number	:

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

Provider Enumeration Date	:	05/12/2026
Last Update Date	:	05/12/2026

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Directions to “ ROBIN MELVILLE ” Practice Location

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