Provider Demographics
NPI:1225656051
Name:MOFIELD, MELANIE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:MOFIELD
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E 17TH STREET
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-4608
Mailing Address - Country:US
Mailing Address - Phone:307-631-9931
Mailing Address - Fax:307-635-7706
Practice Address - Street 1:300 E 17TH STREET
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-4608
Practice Address - Country:US
Practice Address - Phone:307-631-9931
Practice Address - Fax:307-635-7706
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-08
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLCSW-15121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical