Provider Demographics
NPI:1346853876
Name:BRANSCOM, MELINA
Entity type:Individual
Prefix:
First Name:MELINA
Middle Name:
Last Name:BRANSCOM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1185 IROQUOIS RUN
Mailing Address - Street 2:
Mailing Address - City:MACEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44056-1336
Mailing Address - Country:US
Mailing Address - Phone:330-840-8449
Mailing Address - Fax:
Practice Address - Street 1:1185 IROQUOIS RUN
Practice Address - Street 2:
Practice Address - City:MACEDONIA
Practice Address - State:OH
Practice Address - Zip Code:44056-1336
Practice Address - Country:US
Practice Address - Phone:330-840-8449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2303638101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional