MEDICARE: MS. MELISSA LYNN MEUZELAAR M.A., 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	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor	5376	CO

General Provider Information

NPI Number	:	1912191693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELISSA LYNN MEUZELAAR M.A., L.P.C.

Provider Business Mailing Address
First Line	:	2470 S DEFRAME ST
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80228-4709
Country	:	US
Telephone Number	:	720-273-5973
Fax Number	:

Provider Business Practice Location Address
First Line	:	12211 W ALAMEDA PKWY STE 105
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80228-2825
Country	:	US
Telephone Number	:	720-273-5973
Fax Number	:

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

Provider Enumeration Date	:	09/05/2007
Last Update Date	:	12/13/2019

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