Provider Demographics
NPI:1982971685
Name:MILLER, MELODY ANN (LMHC, QHP)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:ANN
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMHC, QHP
Other - Prefix:
Other - First Name:MELODY
Other - Middle Name:ANN
Other - Last Name:MILLER-BEZEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:QHP
Mailing Address - Street 1:PO BOX 1633
Mailing Address - Street 2:
Mailing Address - City:NIAGARA UNIVERSITY
Mailing Address - State:NY
Mailing Address - Zip Code:14109-1633
Mailing Address - Country:US
Mailing Address - Phone:716-341-9258
Mailing Address - Fax:716-402-1204
Practice Address - Street 1:1879 WHITEHAVEN RD # 3006
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NY
Practice Address - Zip Code:14072-1885
Practice Address - Country:US
Practice Address - Phone:716-341-9258
Practice Address - Fax:716-402-1204
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2023-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008631101Y00000X, 101YM0800X, 101YM0800X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor