Provider Demographics
NPI:1174032361
Name:ESTERLING, MELISSA (MA, LPC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ESTERLING
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:MARGARET
Other - Last Name:ESTERLING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA LPC
Mailing Address - Street 1:PO BOX 212
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:MI
Mailing Address - Zip Code:49451-0212
Mailing Address - Country:US
Mailing Address - Phone:616-881-1177
Mailing Address - Fax:
Practice Address - Street 1:12452 STAFFORD ST STE A
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:MI
Practice Address - Zip Code:49451-5103
Practice Address - Country:US
Practice Address - Phone:231-798-5220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401019566101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional