Individual
MELISSA J SUMMERFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
10134 N PORT WASHINGTON RD, MEQUON, WI 53092-5700
(262) 241-9881
Mailing address
5517 W WATERFORD LN STE G, APPLETON, WI 54913-8512
(920) 358-0165
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
761-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0085
REGISTERED PLAY THERAPIST
CA
01
—
761-125
LICENSED PROFESSIONAL COUNSELOR
WI
Enumeration date
10/16/2006
Last updated
03/17/2018
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