Provider Demographics
NPI:1497724405
Name:STRACHAN, MELISSA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:STRACHAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:KINSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1278 JUNGERMANN RD STE E
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-6964
Mailing Address - Country:US
Mailing Address - Phone:636-486-6558
Mailing Address - Fax:636-244-3084
Practice Address - Street 1:1278 JUNGERMANN RD STE E
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-6964
Practice Address - Country:US
Practice Address - Phone:636-486-6558
Practice Address - Fax:636-244-3084
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002028008103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO497291609Medicaid
MO497291609Medicaid