MEDICARE: MRS. MELISSA MICHELLE REID LMSW, ACSW

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	6801081342	MI

General Provider Information

NPI Number	:	1598854887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELISSA MICHELLE REID LMSW, ACSW

Provider Business Mailing Address
First Line	:	5124 W MCMILLAN RD
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49445-9638
Country	:	US
Telephone Number	:	231-343-0095
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 W COLBY ST
Second Line	:	STE E
City	:	WHITEHALL
State	:	MI
Zip	:	49461-1084
Country	:	US
Telephone Number	:	231-343-0095
Fax Number	:	231-725-7241

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

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	10/03/2016

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