Provider Demographics
NPI:1952791741
Name:BLUMELL, MELISSA J (CMHC)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:J
Last Name:BLUMELL
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 W 520 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-4695
Mailing Address - Country:US
Mailing Address - Phone:801-225-4027
Mailing Address - Fax:801-406-0089
Practice Address - Street 1:244 W 520 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-4695
Practice Address - Country:US
Practice Address - Phone:801-225-4027
Practice Address - Fax:801-406-0089
Is Sole Proprietor?:No
Enumeration Date:2015-01-30
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9838277-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health