Provider Demographics
NPI:1124402797
Name:RICHTER, MELINDA (LMSW)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:RICHTER
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 1:2521 UNIVERSITY BLVD
Mailing Address - Street 2:STE 121
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-8629
Mailing Address - Country:US
Mailing Address - Phone:515-598-3300
Mailing Address - Fax:
Practice Address - Street 1:2521 UNIVERSITY BLVD
Practice Address - Street 2:STE 121
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-8629
Practice Address - Country:US
Practice Address - Phone:515-598-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0769491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical