Provider Demographics
NPI:1205436151
Name:FOLEY, MELISSA M (PHD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:M
Last Name:FOLEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 798
Mailing Address - Street 2:
Mailing Address - City:ROCKY FORD
Mailing Address - State:CO
Mailing Address - Zip Code:81067-0798
Mailing Address - Country:US
Mailing Address - Phone:719-225-0311
Mailing Address - Fax:
Practice Address - Street 1:1119 S 12TH ST
Practice Address - Street 2:
Practice Address - City:ROCKY FORD
Practice Address - State:CO
Practice Address - Zip Code:81067-2409
Practice Address - Country:US
Practice Address - Phone:719-249-1404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSYC.00014417101YM0800X
COLPC.0020825101YM0800X
CONLC.0103911101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty