Provider Demographics
NPI:1477364776
Name:BANFIELD, MELINDA (LCSW)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:BANFIELD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:
Other - Last Name:SCHAEFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15285 WATERTOWN PLANK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:ELM GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53122-2339
Mailing Address - Country:US
Mailing Address - Phone:414-552-8242
Mailing Address - Fax:
Practice Address - Street 1:15285 WATERTOWN PLANK RD STE 102
Practice Address - Street 2:
Practice Address - City:ELM GROVE
Practice Address - State:WI
Practice Address - Zip Code:53122-2339
Practice Address - Country:US
Practice Address - Phone:414-552-8242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11811-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical