Provider Demographics
NPI:1710316799
Name:ANDRZEJEWSKI, MELINDA (MS, LPC)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:ANDRZEJEWSKI
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7319 W LAPHAM ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53214-4731
Mailing Address - Country:US
Mailing Address - Phone:414-477-0313
Mailing Address - Fax:
Practice Address - Street 1:7319 W LAPHAM ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53214-4731
Practice Address - Country:US
Practice Address - Phone:414-477-0313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-11
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5215-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional