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Individual

JENNIFER JO MELLUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
702 E BELL RD STE 107, PHOENIX, AZ 85022-6639
(602) 482-7311
Mailing address
28923 N 124TH GLN, PEORIA, AZ 85383-0366
(808) 463-2765

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
60899386
WA
101YM0800X
Mental Health Counselor
LH61109476
WA
101YP2500X
Professional Counselor
Primary
LPC22918
AZ

Other

Enumeration date
10/25/2018
Last updated
04/28/2025
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