Provider Demographics
NPI:1063007755
Name:MELOT, ALAN (LPC)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:MELOT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1627 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-0398
Mailing Address - Country:US
Mailing Address - Phone:417-627-9601
Mailing Address - Fax:417-627-9032
Practice Address - Street 1:1627 W 26TH ST
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-0398
Practice Address - Country:US
Practice Address - Phone:417-627-9601
Practice Address - Fax:417-627-9032
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022014693101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional