Provider Demographics
NPI:1053318204
Name:SCHOTT, MELISSA MICHELE (LCSW LAC)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:MICHELE
Last Name:SCHOTT
Suffix:
Gender:F
Credentials:LCSW LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4747 BRANT RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80911-3173
Mailing Address - Country:US
Mailing Address - Phone:719-338-7214
Mailing Address - Fax:719-475-0993
Practice Address - Street 1:9300 DEWITT LOOP
Practice Address - Street 2:
Practice Address - City:FT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-5285
Practice Address - Country:US
Practice Address - Phone:571-432-2780
Practice Address - Fax:571-231-6762
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD-106101YA0400X
COCSW-2181041C0700X
COCSW-1281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO801769Medicare ID - Type Unspecified