Organization
MELANIE JOHNSON, LCSW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY L BEESON (OWNER, BILLING CO.)
(317) 863-2593
Entity
Organization
Contact information
Practice address
522 BELVEDERE DR, KOKOMO, IN 46901-5627
(765) 453-4527
(317) 863-2602
Mailing address
9979 ORANGE BLOSSOM TRL, FISHERS, IN 46038-7447
(317) 863-2593
(317) 863-2602
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004095A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871574475
INDIVIDUAL NPI
IN
Enumeration date
06/27/2008
Last updated
06/27/2008
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