Provider Demographics
NPI:1326866310
Name:LANCASTER, MELISSA DAWN (MS)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:DAWN
Last Name:LANCASTER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3123 W COUNTY ROAD 100 S
Mailing Address - Street 2:
Mailing Address - City:GREENCASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:46135-8492
Mailing Address - Country:US
Mailing Address - Phone:812-276-8617
Mailing Address - Fax:
Practice Address - Street 1:1 N CALBERT WAY STE B
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:IN
Practice Address - Zip Code:46135-7336
Practice Address - Country:US
Practice Address - Phone:765-653-2781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1155471103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool