Provider Demographics
NPI:1427641182
Name:HILDEBRAND, MELISSA (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:HILDEBRAND
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1961 CARR AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-5204
Mailing Address - Country:US
Mailing Address - Phone:360-603-2764
Mailing Address - Fax:
Practice Address - Street 1:2313 E BADGER RD
Practice Address - Street 2:
Practice Address - City:EVERSON
Practice Address - State:WA
Practice Address - Zip Code:98247-9328
Practice Address - Country:US
Practice Address - Phone:901-654-7178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-13
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000004853101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor