Provider Demographics
NPI:1235906116
Name:HANDT, MELISSA (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:HANDT
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:OTTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LICSW
Mailing Address - Street 1:2031 ROWLAND RD
Mailing Address - Street 2:
Mailing Address - City:MORA
Mailing Address - State:MN
Mailing Address - Zip Code:55051-7119
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2031 ROWLAND RD
Practice Address - Street 2:
Practice Address - City:MORA
Practice Address - State:MN
Practice Address - Zip Code:55051-7119
Practice Address - Country:US
Practice Address - Phone:320-364-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical