Individual
MELINDA GAIL HIMSTEDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1520 KANAWHA BLVD E, CHARLESTON, WV 25311-2413
(681) 265-9047
(681) 265-9210
Mailing address
PO BOX 9569, SOUTH CHARLESTON, WV 25309-0569
(681) 265-9047
(681) 265-9210
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
CP00944410
WV
1041C0700X
Clinical Social Worker
Primary
DP00944410
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0023815000
—
WV
Enumeration date
07/28/2014
Last updated
10/10/2023
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