Provider Demographics
NPI:1295299006
Name:SHOBE-WIERWILLE, MELANIE MAE (LPCC)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:MAE
Last Name:SHOBE-WIERWILLE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-1835
Mailing Address - Country:US
Mailing Address - Phone:419-226-9171
Mailing Address - Fax:419-996-5432
Practice Address - Street 1:1875 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-1835
Practice Address - Country:US
Practice Address - Phone:419-226-9171
Practice Address - Fax:419-996-5432
Is Sole Proprietor?:No
Enumeration Date:2019-01-25
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2001708101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional