Provider Demographics
NPI:1205036068
Name:LUMBREZER, MELANIE KAY (MS, LPCC-SUPV)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:KAY
Last Name:LUMBREZER
Suffix:
Gender:F
Credentials:MS, LPCC-SUPV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 N WEST ST
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-4332
Mailing Address - Country:US
Mailing Address - Phone:419-221-3072
Mailing Address - Fax:419-225-8878
Practice Address - Street 1:222 MCTIGUE DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-5164
Practice Address - Country:US
Practice Address - Phone:419-442-7702
Practice Address - Fax:419-225-8878
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0800057-SUPV101YM0800X
OHC.0800057101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty