Provider Demographics
NPI:1053671248
Name:GOETSCH, HALEY MELISSA (MA)
Entity Type:Individual
Prefix:MISS
First Name:HALEY
Middle Name:MELISSA
Last Name:GOETSCH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 BROTHER BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38133-8950
Mailing Address - Country:US
Mailing Address - Phone:901-251-5000
Mailing Address - Fax:
Practice Address - Street 1:565 UNION ST NE STE 100
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-2416
Practice Address - Country:US
Practice Address - Phone:971-719-2440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator