Provider Demographics
NPI:1689327611
Name:KEY, MELISSA ANN (LAC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:KEY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 FINANCIAL CENTRE PKWY STE 290
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3581
Mailing Address - Country:US
Mailing Address - Phone:501-781-2230
Mailing Address - Fax:
Practice Address - Street 1:100 RIDGEWAY ST STE 2
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-7155
Practice Address - Country:US
Practice Address - Phone:501-781-2230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA2201007101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health