Provider Demographics
NPI:1598025959
Name:RUSSELL-PLUNKETT, MELISSA (MS, NCC, LMHC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:RUSSELL-PLUNKETT
Suffix:
Gender:F
Credentials:MS, NCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 W BROADWAY ST STE 3
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-1267
Mailing Address - Country:US
Mailing Address - Phone:317-604-9889
Mailing Address - Fax:317-300-0949
Practice Address - Street 1:3209 W SMITH VALLEY RD STE 204
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-8510
Practice Address - Country:US
Practice Address - Phone:317-604-9889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-19
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor