Provider Demographics
NPI:1619117074
Name:SOMOGYI, MELINDA LEE (MA, MS)
Entity Type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:LEE
Last Name:SOMOGYI
Suffix:
Gender:F
Credentials:MA, MS
Other - Prefix:MS
Other - First Name:MELINDA
Other - Middle Name:LEE
Other - Last Name:FERLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, MS
Mailing Address - Street 1:11012 N CEDARBURG RD
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-4306
Mailing Address - Country:US
Mailing Address - Phone:262-643-4147
Mailing Address - Fax:
Practice Address - Street 1:1035 W GLEN OAKS LN STE 110
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-3392
Practice Address - Country:US
Practice Address - Phone:262-240-0299
Practice Address - Fax:262-240-0308
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-25
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health