Provider Demographics
NPI:1316104904
Name:WESNER, MELISSA LYNN (LCPC)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:LYNN
Last Name:WESNER
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 1:828 DULANEY VALLEY RD STE 14
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2822
Mailing Address - Country:US
Mailing Address - Phone:410-657-2324
Mailing Address - Fax:
Practice Address - Street 1:828 DULANEY VALLEY RD STE 14
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2822
Practice Address - Country:US
Practice Address - Phone:410-657-2324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3221101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional