Provider Demographics
NPI:1427270578
Name:LIND, MELISSA K
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:K
Last Name:LIND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:K
Other - Last Name:MOREHEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:576 OLIVE ST STE 307
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2995
Mailing Address - Country:US
Mailing Address - Phone:541-344-7303
Mailing Address - Fax:541-344-7303
Practice Address - Street 1:576 OLIVE ST STE 307
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2995
Practice Address - Country:US
Practice Address - Phone:541-344-7303
Practice Address - Fax:541-344-7303
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040062501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical