Provider Demographics
NPI:1457169351
Name:LEETH, MELISSA MARIE (LMHC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:LEETH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:MARIE
Other - Last Name:ZIELINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8465 KEYSTONE XING STE 115
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-2453
Mailing Address - Country:US
Mailing Address - Phone:317-520-8338
Mailing Address - Fax:
Practice Address - Street 1:8465 KEYSTONE XING STE 115
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-2453
Practice Address - Country:US
Practice Address - Phone:317-520-8338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39004015A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health