Provider Demographics
NPI:1306470182
Name:CEREN, MELISSA ANN (LPC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:CEREN
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:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80866-0043
Mailing Address - Country:US
Mailing Address - Phone:864-551-0153
Mailing Address - Fax:
Practice Address - Street 1:4975 AUSTIN BLUFFS PKWY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-5043
Practice Address - Country:US
Practice Address - Phone:864-552-0153
Practice Address - Fax:864-467-2011
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0019562101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health