Provider Demographics
NPI:1902040017
Name:GALE, MELISSA (MA, LPC, LMHP)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:GALE
Suffix:
Gender:F
Credentials:MA, LPC, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W GLYNN DRIVE
Mailing Address - Street 2:
Mailing Address - City:PARKSTON
Mailing Address - State:SD
Mailing Address - Zip Code:57366-9605
Mailing Address - Country:US
Mailing Address - Phone:605-928-7961
Mailing Address - Fax:605-928-4417
Practice Address - Street 1:401 W GLYNN DRIVE
Practice Address - Street 2:
Practice Address - City:PARKSTON
Practice Address - State:SD
Practice Address - Zip Code:57366-9605
Practice Address - Country:US
Practice Address - Phone:605-928-7961
Practice Address - Fax:605-928-4417
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3528101YM0800X
NE1773101YP2500X
SDSD LPC7143101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health