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NPI Code Detail

MEDICARE: MELISSA PEDERSEN

MEDICARE:   MELISSA  PEDERSEN
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
11041C0700XClinical Social WorkerS.2411094OH

General Provider Information

NPI Number : 1841176112
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA PEDERSEN
Provider Business Mailing Address
First Line : 4321 YORK RD SW
Second Line :
City : PATASKALA
State : OH
Zip : 43062-8457
Country : US
Telephone Number : 509-280-6900
Fax Number :
Provider Business Practice Location Address
First Line : 2 EASTON OVAL STE 115
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-6042
Country : US
Telephone Number : 509-280-6900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2025
Last Update Date : 08/13/2025

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Directions to “ MELISSA PEDERSEN ” Practice Location

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