Provider Demographics
NPI:1306148051
Name:SWARTZ, MELISSA (LPC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SWARTZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E BURR BLVD
Mailing Address - Street 2:
Mailing Address - City:KEARNEYSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25430-4793
Mailing Address - Country:US
Mailing Address - Phone:681-252-1632
Mailing Address - Fax:304-555-3743
Practice Address - Street 1:150 E BURR BLVD
Practice Address - Street 2:
Practice Address - City:KEARNEYSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25430
Practice Address - Country:US
Practice Address - Phone:681-255-2163
Practice Address - Fax:304-555-3743
Is Sole Proprietor?:No
Enumeration Date:2010-12-01
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP3505101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional