Provider Demographics
NPI:1588036230
Name:GALYEN, MELODIE KAROL (MS, LPC)
Entity Type:Individual
Prefix:
First Name:MELODIE
Middle Name:KAROL
Last Name:GALYEN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:MELODIE
Other - Middle Name:KAROL
Other - Last Name:ROUTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11557 W SAN REMO DR
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-8307
Mailing Address - Country:US
Mailing Address - Phone:208-617-0768
Mailing Address - Fax:
Practice Address - Street 1:4696 W. OVERLAND RD.
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704
Practice Address - Country:US
Practice Address - Phone:208-515-1660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-21
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID5918101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional