Provider Demographics
NPI:1194928960
Name:MELLOR, ERIKA MARIE (MA)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:MARIE
Last Name:MELLOR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:MARIE
Other - Last Name:OELSNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1010 CAUGHLIN XING STE 200
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89519-0612
Mailing Address - Country:US
Mailing Address - Phone:775-622-9900
Mailing Address - Fax:775-622-9928
Practice Address - Street 1:1010 CAUGHLIN XING STE 200
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89519-0612
Practice Address - Country:US
Practice Address - Phone:775-622-9900
Practice Address - Fax:775-622-9928
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0182LC101YA0400X
NV01041106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)