Provider Demographics
NPI:1235978842
Name:SWITZER, MELINDA MOORE (MA, LPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:MOORE
Last Name:SWITZER
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 STONECREST BLVD UNIT 1101
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-6007
Mailing Address - Country:US
Mailing Address - Phone:903-574-3217
Mailing Address - Fax:
Practice Address - Street 1:1850 STONECREST BLVD UNIT 1101
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-6007
Practice Address - Country:US
Practice Address - Phone:903-574-3217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87815101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional