Provider Demographics
NPI:1821109521
Name:MCCUTCHEON, MELISSA (LPCC)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:MCCUTCHEON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23003 CHANDLERS LN
Mailing Address - Street 2:335
Mailing Address - City:OLMSTED FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44138-3266
Mailing Address - Country:US
Mailing Address - Phone:216-225-4461
Mailing Address - Fax:440-239-1925
Practice Address - Street 1:32626 DETROIT RD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-2013
Practice Address - Country:US
Practice Address - Phone:216-225-4461
Practice Address - Fax:440-239-1925
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE3244101YM0800X
103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy