Provider Demographics
NPI:1407368046
Name:KALLMEYER, MELINDA ANNE (LPC-S)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:ANNE
Last Name:KALLMEYER
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4920 HARRELL ST
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-7938
Mailing Address - Country:US
Mailing Address - Phone:817-846-1082
Mailing Address - Fax:
Practice Address - Street 1:6051 DAVIS BLVD # 821277
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-6385
Practice Address - Country:US
Practice Address - Phone:817-851-2042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-03
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101YM0800X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health