MEDICARE: MS. MELISSA MCCUTCHEON LPCC

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	101YM0800X	Mental Health Counselor	E3244	OH
2	103TP2701X	Group Psychotherapy Psychologist

General Provider Information

NPI Number	:	1821109521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELISSA MCCUTCHEON LPCC

Provider Business Mailing Address
First Line	:	23003 CHANDLERS LN
Second Line	:	335
City	:	OLMSTED FALLS
State	:	OH
Zip	:	44138-3266
Country	:	US
Telephone Number	:	216-225-4461
Fax Number	:	440-239-1925

Provider Business Practice Location Address
First Line	:	32626 DETROIT RD
Second Line	:
City	:	AVON
State	:	OH
Zip	:	44011-2013
Country	:	US
Telephone Number	:	216-225-4461
Fax Number	:	440-239-1925

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	02/15/2012

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