Provider Demographics
NPI:1407308893
Name:BETTES, MELANIE (PPC)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:BETTES
Suffix:
Gender:F
Credentials:PPC
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:HITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10338 CONSER ST APT 1L
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-2613
Mailing Address - Country:US
Mailing Address - Phone:913-203-9554
Mailing Address - Fax:
Practice Address - Street 1:10540 BARKLEY ST STE 269
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1842
Practice Address - Country:US
Practice Address - Phone:913-203-9554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-01
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018043701101YP2500X
WYLPC-1741101YP2500X
KSLCPC2697101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional