Provider Demographics
NPI:1275765190
Name:GENOVA, MELANIE JOY (MSW, LISW-S)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:JOY
Last Name:GENOVA
Suffix:
Gender:F
Credentials:MSW, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 WESTCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-3965
Mailing Address - Country:US
Mailing Address - Phone:330-270-1400
Mailing Address - Fax:330-270-1404
Practice Address - Street 1:136 WESTCHESTER DR
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-3965
Practice Address - Country:US
Practice Address - Phone:330-270-1400
Practice Address - Fax:330-270-1404
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-11
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1101569-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical