Provider Demographics
NPI:1801624150
Name:SCHMALTZ, MELODY (PSYD)
Entity type:Individual
Prefix:DR
First Name:MELODY
Middle Name:
Last Name:SCHMALTZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10501 FGCU BLVD S
Mailing Address - Street 2:COUNSELING AND PSYCHOLOGICAL SERVICES, SCCC 3RD FLOOR
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33965
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10501 FGCU BLVD S
Practice Address - Street 2:COUNSELING AND PSYCHOLOGICAL SERVICES, SCCC 3RD FLOOR
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33965
Practice Address - Country:US
Practice Address - Phone:239-590-7950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11969103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty