Provider Demographics
NPI:1699368456
Name:THORSON, MELISSA ALVAREZ (MS)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ALVAREZ
Last Name:THORSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ALVAREZ
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:409 S 35TH ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-3735
Mailing Address - Country:US
Mailing Address - Phone:406-699-0666
Mailing Address - Fax:
Practice Address - Street 1:1445 AVENUE B
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3146
Practice Address - Country:US
Practice Address - Phone:406-696-2814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-12
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LAC-LIC-49962101YA0400X
MTBBH-ACLC-LIC-44259101YA0400X
MTBBH-LCPC-LIC-57127101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)