Provider Demographics
NPI:1922057868
Name:DEARMONT, MELISSA (MSW,LCSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:DEARMONT
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 75 BOX 149
Mailing Address - Street 2:
Mailing Address - City:ROSE
Mailing Address - State:NE
Mailing Address - Zip Code:68714-9727
Mailing Address - Country:US
Mailing Address - Phone:402-684-2908
Mailing Address - Fax:402-684-3822
Practice Address - Street 1:HC 75 BOX 149
Practice Address - Street 2:
Practice Address - City:ROSE
Practice Address - State:NE
Practice Address - Zip Code:68714-9727
Practice Address - Country:US
Practice Address - Phone:402-684-2908
Practice Address - Fax:402-684-3822
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2891101YM0800X
NE1162104100000X
NE257101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE85517OtherBC/BS
NE100253381-00Medicaid
NE100253381-00Medicaid