Provider Demographics
NPI:1922057868
Name:DEARMONT, MELISSA (MSW,LICSW, LIMHP, CM)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:DEARMONT
Suffix:
Gender:F
Credentials:MSW,LICSW, LIMHP, CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84772 FILLY LANE
Mailing Address - Street 2:
Mailing Address - City:ROSE
Mailing Address - State:NE
Mailing Address - Zip Code:68714-6128
Mailing Address - Country:US
Mailing Address - Phone:402-760-3002
Mailing Address - Fax:402-913-3454
Practice Address - Street 1:407 S CLARK ST
Practice Address - Street 2:
Practice Address - City:BASSETT
Practice Address - State:NE
Practice Address - Zip Code:68714-5062
Practice Address - Country:US
Practice Address - Phone:402-684-2908
Practice Address - Fax:402-913-3454
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE257101YM0800X
NE1162104100000X
NE2891101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100253381-00Medicaid
NE85517OtherBC/BS
NE100253381-00Medicaid