Mellon, Michael W

Mellon, Michael W is an individual health care provider with primary practice located at 3333 Burnet Avenue Ml 5021, Cincinnati OH 45229-3039. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Mellon, Michael W can be contacted via phone (513) 636-4225.

Contact Information

Primary practice address
3333 Burnet Avenue Ml 5021 Cincinnati OH 45229-3039
Phone: (513) 636-4225
Fax: (513) 636-2511
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 6611 Ohio
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X LP4195 Minnesota

Profile Details

NPI number 1023088804
LBN Legal business name Mellon, Michael W
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2006
Last updated Mar 31st, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023088804 NPPES
Minnesota MEDICAID 811579600
Minnesota Other 680011889

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