Provider Demographics
NPI:1194589861
Name:MAER, MELISSA BROOKE (PLPC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:BROOKE
Last Name:MAER
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 LOCKHAVEN CT
Mailing Address - Street 2:
Mailing Address - City:LAKE ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-2400
Mailing Address - Country:US
Mailing Address - Phone:636-214-5814
Mailing Address - Fax:636-214-5817
Practice Address - Street 1:3 LOCKHAVEN CT
Practice Address - Street 2:
Practice Address - City:LAKE ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63367-2400
Practice Address - Country:US
Practice Address - Phone:636-214-5814
Practice Address - Fax:636-214-5817
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022034547101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional