Provider Demographics
NPI:1386947562
Name:BILLQUIST, MELANIE ANN (LPC)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:ANN
Last Name:BILLQUIST
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 1:772 E 510TH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-6849
Mailing Address - Country:US
Mailing Address - Phone:785-806-3868
Mailing Address - Fax:866-826-4066
Practice Address - Street 1:2295 LAWRENCE 2140
Practice Address - Street 2:
Practice Address - City:SARCOXIE
Practice Address - State:MO
Practice Address - Zip Code:64862-8249
Practice Address - Country:US
Practice Address - Phone:417-310-3527
Practice Address - Fax:866-826-4066
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-10
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2207101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional