MEDICARE: MELISSA LAKE L.P.C.

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	PC009052	PA

General Provider Information

NPI Number	:	1881047256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA LAKE L.P.C.

Provider Business Mailing Address
First Line	:	647 PHILADELPHIA ST
Second Line	:	SUITE 403
City	:	INDIANA
State	:	PA
Zip	:	15701-3923
Country	:	US
Telephone Number	:	724-427-5453
Fax Number	:

Provider Business Practice Location Address
First Line	:	647 PHILADELPHIA ST
Second Line	:	SUITE 403
City	:	INDIANA
State	:	PA
Zip	:	15701-3923
Country	:	US
Telephone Number	:	724-427-5453
Fax Number	:

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

Provider Enumeration Date	:	07/20/2016
Last Update Date	:	07/20/2016

Similar Medicare Providers

1265418685 — MRS. KATHLEEN M MARUSA LCSW
Practice Location Address:

647 PHILADELPHIA ST , MIDTOWN BUILDING - SUITE 403
INDIANA, PA
15701-3923

Practice Phone: 724-541-1968
Practice Fax:

1881925485 — GEORGE P DYMIOTIS LPC
Practice Location Address:

647 PHILADELPHIA ST STE 402
INDIANA, PA
15701-3923

Practice Phone: 765-404-6582
Practice Fax: 814-690-2075

1609396381 — LESLIE ANN KRUMMERT MA
Practice Location Address:

647 PHILADELPHIA ST STE 401
INDIANA, PA
15701-3923

Practice Phone: 412-913-4793
Practice Fax:

1649860909 — NICHOLAS JACOB MATALIK
Practice Location Address:

647 PHILADELPHIA ST STE 303
INDIANA, PA
15701-3923

Practice Phone: 724-599-4060
Practice Fax:

1558952184 — MINDFUL ROOTS COUNSELING, LLC
Practice Location Address:

647 PHILADELPHIA ST STE 303
INDIANA, PA
15701-3923

Practice Phone: 724-599-4060
Practice Fax:

1700478922 — ALYSSA MATALIK
Practice Location Address:

647 PHILADELPHIA ST
INDIANA, PA
15701-3923

Practice Phone: 570-706-0064
Practice Fax:

Directions to “ MELISSA LAKE L.P.C.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.