Provider Demographics
NPI:1033626239
Name:LINDEN, MELISA SUE (AAC)
Entity Type:Individual
Prefix:
First Name:MELISA
Middle Name:SUE
Last Name:LINDEN
Suffix:
Gender:F
Credentials:AAC
Other - Prefix:
Other - First Name:MELISA
Other - Middle Name:SUE
Other - Last Name:VALENTINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AAC
Mailing Address - Street 1:PO BOX 1670
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-8014
Mailing Address - Country:US
Mailing Address - Phone:360-749-8056
Mailing Address - Fax:360-749-8060
Practice Address - Street 1:618 14TH AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-1604
Practice Address - Country:US
Practice Address - Phone:360-749-8056
Practice Address - Fax:360-749-8060
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator