Provider Demographics
NPI:1053394635
Name:COMBS, MELINDA F (LCSW, CADAC)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:F
Last Name:COMBS
Suffix:
Gender:F
Credentials:LCSW, CADAC
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:F
Other - Last Name:GOFFINET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, CADAC
Mailing Address - Street 1:515 BAYOU ST
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-1034
Mailing Address - Country:US
Mailing Address - Phone:812-886-6800
Mailing Address - Fax:812-886-6809
Practice Address - Street 1:515 BAYOU ST
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-1034
Practice Address - Country:US
Practice Address - Phone:812-886-6800
Practice Address - Fax:812-886-6809
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005039A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN370997OtherMHN - TRICARE
IN000000334945OtherANTHEM
IN444530JMedicare PIN