Provider Demographics
NPI:1750953402
Name:HAUPTSTUECK, MERISSA (LMHC)
Entity type:Individual
Prefix:
First Name:MERISSA
Middle Name:
Last Name:HAUPTSTUECK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:MERISSA
Other - Middle Name:
Other - Last Name:MILNICKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8920 SOUTHPOINTE DR STE E1
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-7505
Mailing Address - Country:US
Mailing Address - Phone:216-468-5000
Mailing Address - Fax:
Practice Address - Street 1:8920 SOUTHPOINTE DR STE E1
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-7505
Practice Address - Country:US
Practice Address - Phone:216-468-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-13
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN88001100A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health