Provider Demographics
NPI:1619612306
Name:BARTSCH, MELISSA ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:ANN
Last Name:BARTSCH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4757 FOXGLOVE PT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-8018
Mailing Address - Country:US
Mailing Address - Phone:865-591-9724
Mailing Address - Fax:
Practice Address - Street 1:EASTERN KENTUCKY UNIVERSITY COUNSELING CENTER
Practice Address - Street 2:521 LANCASTER AVE., WHITLOCK 571
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-4047
Practice Address - Country:US
Practice Address - Phone:859-622-1303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2619103TC1900X
KY168021103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling