Provider Demographics
NPI:1003648981
Name:DOLIN, MELISSA (CDCA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:DOLIN
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-2725
Mailing Address - Country:US
Mailing Address - Phone:614-432-3165
Mailing Address - Fax:
Practice Address - Street 1:1900 BRICE RD STE B
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-3403
Practice Address - Country:US
Practice Address - Phone:614-239-9965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.187330101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)