Provider Demographics
NPI:1467718221
Name:KLEINZ, MELISSA MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:KLEINZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:MARIE
Other - Last Name:SELLITTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:612 WYNNBROOK RD
Mailing Address - Street 2:
Mailing Address - City:SECANE
Mailing Address - State:PA
Mailing Address - Zip Code:19018-3513
Mailing Address - Country:US
Mailing Address - Phone:610-733-9748
Mailing Address - Fax:
Practice Address - Street 1:1489 BALTIMORE PIKE
Practice Address - Street 2:BLDG 200 SUITE 250
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-3958
Practice Address - Country:US
Practice Address - Phone:610-544-2110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006258101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional