Provider Demographics
NPI:1144424359
Name:HYPPOLITE, MELODY LYNN (MSW)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:LYNN
Last Name:HYPPOLITE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:MELODY
Other - Middle Name:LYNN
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:645 S ROGERS ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-2353
Mailing Address - Country:US
Mailing Address - Phone:812-339-1691
Mailing Address - Fax:812-378-8367
Practice Address - Street 1:720 N MARR RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-6660
Practice Address - Country:US
Practice Address - Phone:812-314-3645
Practice Address - Fax:812-378-8785
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor