Provider Demographics
NPI:1558601187
Name:FRITTS, MELISSA JANE (LSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JANE
Last Name:FRITTS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745-3347
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:216 MAIN ST
Practice Address - Street 2:
Practice Address - City:MILL HALL
Practice Address - State:PA
Practice Address - Zip Code:17751-1705
Practice Address - Country:US
Practice Address - Phone:570-295-2581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-19
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW130126104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker