Provider Demographics
NPI:1982609632
Name:FUCHS, MELINDA (LCSW)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:FUCHS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MINDY
Other - Middle Name:
Other - Last Name:FUCHS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:645 BLOCK RD
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-9061
Mailing Address - Country:US
Mailing Address - Phone:517-617-7431
Mailing Address - Fax:
Practice Address - Street 1:28 W CHICAGO ST
Practice Address - Street 2:SUITE 2C
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-1678
Practice Address - Country:US
Practice Address - Phone:517-279-8478
Practice Address - Fax:517-238-4395
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-18
Last Update Date:2016-08-20
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
MI68010908891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0898805OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
PA7004789OtherAETNA
PA7004789OtherAETNA