Provider Demographics
NPI:1952718330
Name:MELTON, CYNTHIA D (DBH, MSW, LCSW,)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:D
Last Name:MELTON
Suffix:
Gender:F
Credentials:DBH, MSW, LCSW,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 E BRADFORD PKWY
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-4264
Mailing Address - Country:US
Mailing Address - Phone:417-761-5000
Mailing Address - Fax:
Practice Address - Street 1:1300 E BRADFORD PKWY
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-4264
Practice Address - Country:US
Practice Address - Phone:417-761-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-4975-01041C0700X
MELC176201041C0700X
AR8630-C1041C0700X
AZLCSW-211481041C0700X
CA1124711041C0700X
WALW613297111041C0700X
FLSW203461041C0700X
MO20160421161041C0700X
MD292801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical