Provider Demographics
NPI:1518063635
Name:MELOY, LYNN E (LISW)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:E
Last Name:MELOY
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 CLAUDE THOMAS RD
Mailing Address - Street 2:STE 21-F
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-1900
Mailing Address - Country:US
Mailing Address - Phone:937-704-0255
Mailing Address - Fax:937-704-0255
Practice Address - Street 1:8401 CLAUDE THOMAS RD
Practice Address - Street 2:STE 21-F
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-1900
Practice Address - Country:US
Practice Address - Phone:937-704-0255
Practice Address - Fax:937-704-0255
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI2661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH036467000OtherMAGELLAN
OH7387142OtherAETNA
OH000000038054OtherANTHEM
MESW18452Medicare ID - Type Unspecified
R03230Medicare UPIN
MESW18452Medicare PIN