Provider Demographics
NPI:1942428032
Name:MARSHALL, MELISSA K (MSW, LCSW, LCAC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:K
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MSW, LCSW, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11154 SANDERS DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-5347
Mailing Address - Country:US
Mailing Address - Phone:317-219-7001
Mailing Address - Fax:
Practice Address - Street 1:6950 HILLSDALE CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2040
Practice Address - Country:US
Practice Address - Phone:317-621-7740
Practice Address - Fax:317-355-6096
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005167A1041C0700X
IN87000813A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical