Provider Demographics
NPI:1669946000
Name:SIPES, MELANIE ANN
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:ANN
Last Name:SIPES
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 1:907 MORRISON BLVD
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-1719
Mailing Address - Country:US
Mailing Address - Phone:410-913-1883
Mailing Address - Fax:
Practice Address - Street 1:1705 CONOWINGO RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-1815
Practice Address - Country:US
Practice Address - Phone:410-941-0029
Practice Address - Fax:410-941-0029
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-18
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional