Provider Demographics
NPI:1437465127
Name:DELANTY, MELISSA MILLIGAN (MA, LPC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MILLIGAN
Last Name:DELANTY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7360 SW HUNZIKER ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8288
Mailing Address - Country:US
Mailing Address - Phone:503-620-3302
Mailing Address - Fax:503-620-3196
Practice Address - Street 1:7360 SW HUNZIKER ST
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8288
Practice Address - Country:US
Practice Address - Phone:503-620-3302
Practice Address - Fax:503-620-3196
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2510101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health