Individual
MELISSA S CHANCELLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1095 MIDWAY RD, MENASHA, WI 54952-1115
(920) 720-2300
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
(920) 720-2300
(920) 720-3719
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
15413-132
WI
104100000X
Social Worker
134327
WI
1041C0700X
Clinical Social Worker
Primary
134327
WI
Other
Enumeration date
01/12/2012
Last updated
02/14/2025
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