Provider Demographics
NPI:1639407141
Name:SCHNEIDER, MELISSA J (LPC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:J
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:J
Other - Last Name:EGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2300 N MAYFAIR RD
Mailing Address - Street 2:SUITE 425
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-1505
Mailing Address - Country:US
Mailing Address - Phone:414-727-4455
Mailing Address - Fax:414-727-4690
Practice Address - Street 1:2300 N MAYFAIR RD
Practice Address - Street 2:SUITE 425
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-1505
Practice Address - Country:US
Practice Address - Phone:414-727-4455
Practice Address - Fax:414-727-4690
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2009-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4306-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI4306-125OtherSTATE LICENSE