Provider Demographics
NPI:1396737284
Name:PYLE, MELODY HALL (ACSW,LCSW)
Entity type:Individual
Prefix:MRS
First Name:MELODY
Middle Name:HALL
Last Name:PYLE
Suffix:
Gender:F
Credentials:ACSW,LCSW
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 248
Mailing Address - Street 2:
Mailing Address - City:SHARPSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46068-0248
Mailing Address - Country:US
Mailing Address - Phone:765-963-5756
Mailing Address - Fax:
Practice Address - Street 1:618 S MAIN ST
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-5462
Practice Address - Country:US
Practice Address - Phone:765-457-9313
Practice Address - Fax:765-868-4722
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN101YM0800X
IN34003655A101YP2500X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000210915OtherANTHEM BC & BS
IN000000210915OtherANTHEM BC & BS