Individual
MELISSA A FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.,LPC
Contact information
Practice address
S29W29350 ANCESTRAL DR, WAUKESHA, WI 53188-9514
(262) 219-5433
(262) 201-4262
Mailing address
S29W29350 ANCESTRAL DR, WAUKESHA, WI 53188-9514
(262) 219-5433
(262) 201-4262
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2829-125
WI
101YP2500X
Professional Counselor
Primary
2829-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43550000
—
WI
Enumeration date
05/10/2007
Last updated
11/15/2024
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