Provider Demographics
NPI:1710034319
Name:MELTON, DANA MARIE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:MARIE
Last Name:MELTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:DANA
Other - Middle Name:MARIE
Other - Last Name:HALUSKA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:711 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-2113
Mailing Address - Country:US
Mailing Address - Phone:814-502-2502
Mailing Address - Fax:
Practice Address - Street 1:1906 N JUNIATA ST
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-1908
Practice Address - Country:US
Practice Address - Phone:814-695-2984
Practice Address - Fax:814-695-2110
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1623338OtherHIGHMARK