Provider Demographics
NPI:1649535949
Name:CLEVELAND, MELANIE R (LPCC)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:R
Last Name:CLEVELAND
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 1:3550 LEXINGTON AVE N STE 100
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-8048
Mailing Address - Country:US
Mailing Address - Phone:651-853-5565
Mailing Address - Fax:651-853-5566
Practice Address - Street 1:3550 LEXINGTON AVE N STE 100
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-8048
Practice Address - Country:US
Practice Address - Phone:651-853-5565
Practice Address - Fax:651-853-5566
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00479101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health