Provider Demographics
NPI:1164901385
Name:PIZZO, MELISSA (LPC, MA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:PIZZO
Suffix:
Gender:F
Credentials:LPC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11775 WADSWORTH BLVD APT 9211
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-2794
Mailing Address - Country:US
Mailing Address - Phone:802-272-6870
Mailing Address - Fax:
Practice Address - Street 1:11775 WADSWORTH BLVD APT 9211
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-2794
Practice Address - Country:US
Practice Address - Phone:802-272-6870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0014781101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor