Provider Demographics
NPI:1457465387
Name:TRUAX, MELISSA JANE (LCSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JANE
Last Name:TRUAX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8202 CLEARVISTA PKWY STE 7
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-1400
Mailing Address - Country:US
Mailing Address - Phone:317-288-9942
Mailing Address - Fax:317-288-9945
Practice Address - Street 1:8202 CLEARVISTA PKWY STE 7
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-1400
Practice Address - Country:US
Practice Address - Phone:317-288-9942
Practice Address - Fax:317-288-9945
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005276A1041C0700X
IN87000532A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100073590Medicaid
INM400016108Medicare PIN