Provider Demographics
NPI:1497232664
Name:CLINE, MELINDA (LCSW)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:CLINE
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 1:127 N HIGGINS AVE
Mailing Address - Street 2:STE 205
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4457
Mailing Address - Country:US
Mailing Address - Phone:406-493-2890
Mailing Address - Fax:
Practice Address - Street 1:127 N HIGGINS AVE
Practice Address - Street 2:STE 205
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4457
Practice Address - Country:US
Practice Address - Phone:406-493-2890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-20
Last Update Date:2020-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-313731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical