Provider Demographics
NPI:1932513264
Name:CARPENTER-LAY, MELANEE B (LMFT)
Entity Type:Individual
Prefix:
First Name:MELANEE
Middle Name:B
Last Name:CARPENTER-LAY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:MELANEE
Other - Middle Name:CARPENTER
Other - Last Name:SENY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2667 BANYAN TREE LN
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92545-8155
Mailing Address - Country:US
Mailing Address - Phone:714-321-9723
Mailing Address - Fax:
Practice Address - Street 1:950 N RAMONA BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92582-2567
Practice Address - Country:US
Practice Address - Phone:951-487-2674
Practice Address - Fax:951-487-2679
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-14
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106476106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA106H00000XMedicare UPIN