Provider Demographics
NPI:1316017049
Name:MELTZER, MELISSA (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:MELTZER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 117
Mailing Address - Street 2:
Mailing Address - City:MANILLA
Mailing Address - State:IN
Mailing Address - Zip Code:46150
Mailing Address - Country:US
Mailing Address - Phone:317-683-7089
Mailing Address - Fax:
Practice Address - Street 1:2811 S. CROSS ST.
Practice Address - Street 2:
Practice Address - City:MANILLA
Practice Address - State:IN
Practice Address - Zip Code:46150
Practice Address - Country:US
Practice Address - Phone:317-364-3166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001894A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health