Provider Demographics
NPI:1881069185
Name:MAPLES, MELANIE (LCSW, QMHPC, CADCIII)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:MAPLES
Suffix:
Gender:F
Credentials:LCSW, QMHPC, CADCIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:687 CHESHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-5060
Mailing Address - Country:US
Mailing Address - Phone:541-684-4100
Mailing Address - Fax:541-684-4156
Practice Address - Street 1:687 CHESHIRE AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-5060
Practice Address - Country:US
Practice Address - Phone:541-684-4100
Practice Address - Fax:541-648-4156
Is Sole Proprietor?:No
Enumeration Date:2015-12-11
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR23-07-30077101YA0400X
OR22-QMHPC-001158101YM0800X
225400000X
ORL116781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner