Provider Demographics
NPI:1063167419
Name:FELL, MELANIE (TLMHC)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:
Last Name:FELL
Suffix:
Gender:F
Credentials:TLMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC
Mailing Address - State:IA
Mailing Address - Zip Code:50022-2879
Mailing Address - Country:US
Mailing Address - Phone:712-254-9018
Mailing Address - Fax:
Practice Address - Street 1:101 E 22ND ST
Practice Address - Street 2:
Practice Address - City:ATLANTIC
Practice Address - State:IA
Practice Address - Zip Code:50022-2879
Practice Address - Country:US
Practice Address - Phone:712-254-9018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA111254101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health