MEDICARE: MELISSA STURGES PCC

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	E.0700931	OH

General Provider Information

NPI Number	:	1568602449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA STURGES PCC

Provider Business Mailing Address
First Line	:	1262 THOREAU RD
Second Line	:
City	:	LAKEWOOD
State	:	OH
Zip	:	44107-2844
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20033 DETROIT RD
Second Line	:	201
City	:	ROCKY RIVER
State	:	OH
Zip	:	44116-2400
Country	:	US
Telephone Number	:	802-578-4972
Fax Number	:

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

Provider Enumeration Date	:	03/04/2009
Last Update Date	:	03/04/2009

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