Provider Demographics
NPI:1275221061
Name:HALL, MELINDA ANN (LMHC)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:ANN
Last Name:HALL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 SW 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-2502
Mailing Address - Country:US
Mailing Address - Phone:954-224-8368
Mailing Address - Fax:
Practice Address - Street 1:13180 N CLEVELAND AVE STE 339
Practice Address - Street 2:
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-6232
Practice Address - Country:US
Practice Address - Phone:239-402-4010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7525101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health