Provider Demographics
NPI:1346678950
Name:ALDRICH, MELISSA (LMSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ALDRICH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:ALDRICH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LLMSW
Mailing Address - Street 1:29148 LEESBURG CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-2436
Mailing Address - Country:US
Mailing Address - Phone:734-812-5333
Mailing Address - Fax:
Practice Address - Street 1:1055 SOUTH BLVD E STE 210
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-5467
Practice Address - Country:US
Practice Address - Phone:248-218-0238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010895361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical