Provider Demographics
NPI:1306069604
Name:BELANGIE, MELODEE LYMAN (LCPC)
Entity type:Individual
Prefix:MS
First Name:MELODEE
Middle Name:LYMAN
Last Name:BELANGIE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 W KENT AVE
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-6730
Mailing Address - Country:US
Mailing Address - Phone:406-541-4325
Mailing Address - Fax:406-542-1032
Practice Address - Street 1:129 W KENT AVE
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-6730
Practice Address - Country:US
Practice Address - Phone:406-541-4325
Practice Address - Fax:406-542-1032
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT943101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT744413OtherBLUE CROSS BLUE SHIELD
MT0254201Medicaid