Provider Demographics
NPI:1194249557
Name:BEGICH, MELISSA PAIGE (LPC-S)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:PAIGE
Last Name:BEGICH
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 212034
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99521-2034
Mailing Address - Country:US
Mailing Address - Phone:907-360-5352
Mailing Address - Fax:
Practice Address - Street 1:4545 CAMPBELL PARK LOOP
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-1165
Practice Address - Country:US
Practice Address - Phone:907-360-5352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-27
Last Update Date:2017-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
AK108864101YM0800X
AKPCOP711101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health