Individual
MELISSA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
600 N EAGLESON AVE, BLOOMINGTON, IN 47405-3190
(128) 855-5711
Mailing address
600 N EAGLESON AVE, BLOOMINGTON, IN 47405-3190
(128) 855-5711
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
39004156A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C.1801236
COUNSELOR, SOCIAL WORKER AND MFT BOARD
OH
Enumeration date
07/12/2018
Last updated
04/27/2022
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