Provider Demographics
NPI:1124591771
Name:HENBEST, MELISSA MARIE (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:MARIE
Last Name:HENBEST
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MRS
Other - First Name:MELISSA
Other - Middle Name:M
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:296 W. SUNSET AVE
Mailing Address - Street 2:STE 15
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-8366
Mailing Address - Country:US
Mailing Address - Phone:208-666-0357
Mailing Address - Fax:208-666-0468
Practice Address - Street 1:296 W. SUNSET AVE
Practice Address - Street 2:STE 15
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-8366
Practice Address - Country:US
Practice Address - Phone:208-666-0357
Practice Address - Fax:208-666-0468
Is Sole Proprietor?:No
Enumeration Date:2019-01-07
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSE-203170101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health