Provider Demographics
NPI:1932468816
Name:GETZKIN, MELISSA LYNN (MA, LPC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LYNN
Last Name:GETZKIN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4105 LAKE DRIVE AVE N
Mailing Address - Street 2:
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-1584
Mailing Address - Country:US
Mailing Address - Phone:612-518-0935
Mailing Address - Fax:
Practice Address - Street 1:17113 MINNETONKA BLVD
Practice Address - Street 2:WEST ENTERENCE
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-1100
Practice Address - Country:US
Practice Address - Phone:855-456-8567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN01162101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional