Provider Demographics
NPI:1013247519
Name:SLATZER, MELISSA S (LPC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:S
Last Name:SLATZER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:S
Other - Last Name:NOLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC-S
Mailing Address - Street 1:11473 GEIB AVE NE
Mailing Address - Street 2:
Mailing Address - City:HARTVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44632-8725
Mailing Address - Country:US
Mailing Address - Phone:330-268-6467
Mailing Address - Fax:
Practice Address - Street 1:11473 GEIB AVE NE
Practice Address - Street 2:
Practice Address - City:HARTVILLE
Practice Address - State:OH
Practice Address - Zip Code:44632-8725
Practice Address - Country:US
Practice Address - Phone:330-268-6467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-05
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0800169-SUPV101YP2500X
OHC 0800169101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0290822Medicaid