Provider Demographics
NPI:1720143977
Name:MEE, MELISSA JANE (LCPC)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:JANE
Last Name:MEE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:854 W BLUE DOWNS ST
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-7913
Mailing Address - Country:US
Mailing Address - Phone:641-431-0045
Mailing Address - Fax:
Practice Address - Street 1:854 W BLUE DOWNS ST
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-7913
Practice Address - Country:US
Practice Address - Phone:641-431-0045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA009561041C0700X
IDLCPC-5144101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical