Provider Demographics
NPI:1801120415
Name:SQUIRES-WILLIAMS, MELISSA (LMC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SQUIRES-WILLIAMS
Suffix:
Gender:
Credentials:LMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 7TH STREET
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403
Mailing Address - Country:US
Mailing Address - Phone:509-334-1133
Mailing Address - Fax:509-332-1608
Practice Address - Street 1:900 7TH STREET
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403
Practice Address - Country:US
Practice Address - Phone:509-758-3341
Practice Address - Fax:509-332-1608
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009084101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health