Provider Demographics
NPI:1225750250
Name:FLEWELLING, MELISSA SUE (LCPC-C)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:SUE
Last Name:FLEWELLING
Suffix:
Gender:F
Credentials:LCPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 CALLAGHAN RD
Mailing Address - Street 2:
Mailing Address - City:HOULTON
Mailing Address - State:ME
Mailing Address - Zip Code:04730-3756
Mailing Address - Country:US
Mailing Address - Phone:207-538-1102
Mailing Address - Fax:
Practice Address - Street 1:421 CALLAGHAN RD
Practice Address - Street 2:
Practice Address - City:HOULTON
Practice Address - State:ME
Practice Address - Zip Code:04730-3756
Practice Address - Country:US
Practice Address - Phone:207-538-1102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL6786101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional