Provider Demographics
NPI:1740540657
Name:MELSETH, LINDA L (LMHC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:MELSETH
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 1:1500 CONRAD RD
Mailing Address - Street 2:
Mailing Address - City:SELAH
Mailing Address - State:WA
Mailing Address - Zip Code:98942-9778
Mailing Address - Country:US
Mailing Address - Phone:360-204-9428
Mailing Address - Fax:
Practice Address - Street 1:1250 SE GODSEY RD
Practice Address - Street 2:#52
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338-2790
Practice Address - Country:US
Practice Address - Phone:360-204-9428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-24
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60122606101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health