Provider Demographics
NPI:1053066308
Name:SMEESTER, MELISSA (MA, LPCA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SMEESTER
Suffix:
Gender:F
Credentials:MA, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:952 CAPITOL ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-1201
Mailing Address - Country:US
Mailing Address - Phone:425-354-8223
Mailing Address - Fax:
Practice Address - Street 1:960 BROADWAY ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-1275
Practice Address - Country:US
Practice Address - Phone:503-487-5242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR7320101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional