Provider Demographics
NPI:1184360406
Name:MOLYNEUX, MELISSA (LISW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:MOLYNEUX
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2685 ARMSTRONG RD
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-9041
Mailing Address - Country:US
Mailing Address - Phone:330-962-1764
Mailing Address - Fax:
Practice Address - Street 1:2148 EAGLE PASS
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-5356
Practice Address - Country:US
Practice Address - Phone:330-345-8970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-10
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2308663104100000X
1041C0700X
OHI.25069041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker