Provider Demographics
NPI:1205897634
Name:FLOOD, MELISSA KAY (LICSW, ACSW, BCD)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:KAY
Last Name:FLOOD
Suffix:
Gender:F
Credentials:LICSW, ACSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 15TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-5997
Mailing Address - Country:US
Mailing Address - Phone:701-852-7100
Mailing Address - Fax:
Practice Address - Street 1:901 15TH AVE SE
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-5997
Practice Address - Country:US
Practice Address - Phone:701-852-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND45051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical