Provider Demographics
NPI:1720219702
Name:GALBRETH, MELISSA (LMHC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:GALBRETH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3554 PROMENADE PKWY STE H
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47909-8418
Mailing Address - Country:US
Mailing Address - Phone:765-471-1100
Mailing Address - Fax:765-471-1009
Practice Address - Street 1:3554 PROMENADE PKWY STE H
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47909-8418
Practice Address - Country:US
Practice Address - Phone:765-471-1100
Practice Address - Fax:765-471-1009
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-07
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001618A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health