Provider Demographics
NPI:1407668783
Name:MELISA HOLDWAY LMHC PLLC
Entity type:Organization
Organization Name:MELISA HOLDWAY LMHC PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLDWAY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:509-565-0686
Mailing Address - Street 1:PO BOX 997
Mailing Address - Street 2:
Mailing Address - City:MEDICAL LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99022-0997
Mailing Address - Country:US
Mailing Address - Phone:509-721-0290
Mailing Address - Fax:509-565-3025
Practice Address - Street 1:107 W LAKE STREET
Practice Address - Street 2:SUITE C
Practice Address - City:MEDICAL LAKE
Practice Address - State:WA
Practice Address - Zip Code:99022
Practice Address - Country:US
Practice Address - Phone:509-721-0290
Practice Address - Fax:509-565-3025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-23
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1013415223OtherNPI
1699091868OtherNPI