Provider Demographics
NPI:1891938882
Name:MELCHIOR, MONICA M (LCSW)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:M
Last Name:MELCHIOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 CLARK AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDIVE
Mailing Address - State:MT
Mailing Address - Zip Code:59330-1400
Mailing Address - Country:US
Mailing Address - Phone:406-989-0541
Mailing Address - Fax:
Practice Address - Street 1:807 CLARK AVE
Practice Address - Street 2:
Practice Address - City:GLENDIVE
Practice Address - State:MT
Practice Address - Zip Code:59330-1400
Practice Address - Country:US
Practice Address - Phone:406-989-0541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-07
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical