Provider Demographics
NPI:1417134818
Name:SCOLARO, MELISSA T (LCSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:T
Last Name:SCOLARO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8820 LADUE RD.
Mailing Address - Street 2:STE. 306
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124
Mailing Address - Country:US
Mailing Address - Phone:314-561-3191
Mailing Address - Fax:
Practice Address - Street 1:8820 LADUE RD.
Practice Address - Street 2:STE. 306
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124
Practice Address - Country:US
Practice Address - Phone:314-561-3191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20060058531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical