Provider Demographics
NPI:1518365287
Name:CROY, MELANIE A (LPC - UNDER SUPERVIS)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:A
Last Name:CROY
Suffix:
Gender:F
Credentials:LPC - UNDER SUPERVIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 N. HARRISON
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74801
Mailing Address - Country:US
Mailing Address - Phone:405-481-7187
Mailing Address - Fax:405-481-7219
Practice Address - Street 1:1605 N. HARRISON
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801
Practice Address - Country:US
Practice Address - Phone:405-481-7187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-12
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health