Provider Demographics
NPI:1780861799
Name:WINTERSCHEID, MELISSA SUZANNE (LPC)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:SUZANNE
Last Name:WINTERSCHEID
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5533 E 48TH PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-6902
Mailing Address - Country:US
Mailing Address - Phone:918-906-2782
Mailing Address - Fax:918-289-2624
Practice Address - Street 1:10310 N 138TH EAST AVE STE 104
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-4611
Practice Address - Country:US
Practice Address - Phone:918-906-2782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5366101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200389110BMedicaid