Provider Demographics
NPI:1043903354
Name:KING, MELANIE ROCHELLE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:ROCHELLE
Last Name:KING
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 N HIGH SCHOOL RD STE 6
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46214-5702
Mailing Address - Country:US
Mailing Address - Phone:317-282-3088
Mailing Address - Fax:317-295-2555
Practice Address - Street 1:855 N HIGH SCHOOL RD STE 6
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46214-5702
Practice Address - Country:US
Practice Address - Phone:317-282-3088
Practice Address - Fax:317-295-2555
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33011291A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker