Provider Demographics
NPI:1801169743
Name:SCHALLER, MELISSA ANN (LPCC-S, LSW)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANN
Last Name:SCHALLER
Suffix:
Gender:F
Credentials:LPCC-S, LSW
Other - Prefix:MRS
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:BAUMGARTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PCC, LSW
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-0400
Mailing Address - Country:US
Mailing Address - Phone:419-868-1178
Mailing Address - Fax:419-868-1989
Practice Address - Street 1:6715 DORR ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-4207
Practice Address - Country:US
Practice Address - Phone:419-868-1178
Practice Address - Fax:419-868-1989
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE. 0008437101Y00000X
OHS. 0027132104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker