Provider Demographics
NPI:1548883044
Name:MELEKA, MICHELLE (MA)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MELEKA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 W WASHINGTON LN APT 2F
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-2656
Mailing Address - Country:US
Mailing Address - Phone:443-474-2009
Mailing Address - Fax:
Practice Address - Street 1:301 W 15TH ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-5300
Practice Address - Country:US
Practice Address - Phone:610-619-8799
Practice Address - Fax:610-619-8351
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health