MEDICARE: MELISSA KELCH LPC

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	6401011631	MI

General Provider Information

NPI Number	:	1891178430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA KELCH LPC

Provider Business Mailing Address
First Line	:	42815 GARFIELD RD
Second Line	:	SUITE 210
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48038-1143
Country	:	US
Telephone Number	:	248-568-1849
Fax Number	:	586-408-6485

Provider Business Practice Location Address
First Line	:	42815 GARFIELD RD
Second Line	:	SUITE 210
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48038-1143
Country	:	US
Telephone Number	:	248-568-1849
Fax Number	:	586-408-6485

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

Provider Enumeration Date	:	07/01/2015
Last Update Date	:	02/02/2016

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Directions to “ MELISSA KELCH LPC” Practice Location

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