Provider Demographics
NPI:1952114266
Name:WEST, MELANIE YVETTE
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:YVETTE
Last Name:WEST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:YVETTE
Other - Last Name:WEST - SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6562 MERRINGER AVE
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-1029
Mailing Address - Country:US
Mailing Address - Phone:614-377-9201
Mailing Address - Fax:
Practice Address - Street 1:6562 MERRINGER AVE
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-1029
Practice Address - Country:US
Practice Address - Phone:614-377-9201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health