Provider Demographics
NPI:1679003495
Name:ANASTASI-MELCHERT, MIQUEL KATHERINE (LMHC)
Entity Type:Individual
Prefix:
First Name:MIQUEL
Middle Name:KATHERINE
Last Name:ANASTASI-MELCHERT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:MIQUEL
Other - Middle Name:KATHERINE
Other - Last Name:GALINDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1290 JORDAN STREET
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-8020
Mailing Address - Country:US
Mailing Address - Phone:319-356-6352
Mailing Address - Fax:319-358-2367
Practice Address - Street 1:1290 JORDAN STREET
Practice Address - Street 2:
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-8020
Practice Address - Country:US
Practice Address - Phone:319-356-6352
Practice Address - Fax:319-358-2367
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001269101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1801885033OtherNPI
1922097484OtherNPI