Provider Demographics
NPI:1275160509
Name:SCHLETZBAUM, MELISSA
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SCHLETZBAUM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 NE 280TH ST
Mailing Address - Street 2:
Mailing Address - City:LATHROP
Mailing Address - State:MO
Mailing Address - Zip Code:64465-9690
Mailing Address - Country:US
Mailing Address - Phone:816-287-8390
Mailing Address - Fax:
Practice Address - Street 1:10502 N AMBASSADOR DR STE 230
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64153-1232
Practice Address - Country:US
Practice Address - Phone:816-287-8390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20190174051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical