Provider Demographics
NPI:1255830675
Name:PHILLIPS, MELISSA ANNE (LMHC, CPC)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANNE
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:LMHC, CPC
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:ANNE
Other - Last Name:BONNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC, CDPT, SUDPT
Mailing Address - Street 1:3623 E 29TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-5752
Mailing Address - Country:US
Mailing Address - Phone:602-329-9955
Mailing Address - Fax:
Practice Address - Street 1:3623 E 29TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-5752
Practice Address - Country:US
Practice Address - Phone:602-329-9955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO60801341101YA0400X
WALH61163843101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)