Provider Demographics
NPI: | 1679066153 |
---|---|
Name: | MELISSA STRACHAN, PSY.D., LLC |
Entity type: | Organization |
Organization Name: | MELISSA STRACHAN, PSY.D., LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CLINICAL PSYCHOLOGIST |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | MELISSA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | STRACHAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 636-486-6558 |
Mailing Address - Street 1: | 1278 JUNGERMANN RD STE E |
Mailing Address - Street 2: | |
Mailing Address - City: | SAINT PETERS |
Mailing Address - State: | MO |
Mailing Address - Zip Code: | 63376-6964 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 636-486-6558 |
Mailing Address - Fax: | 636-244-3084 |
Practice Address - Street 1: | 1278 JUNGERMANN RD STE E |
Practice Address - Street 2: | |
Practice Address - City: | SAINT PETERS |
Practice Address - State: | MO |
Practice Address - Zip Code: | 63376-6964 |
Practice Address - Country: | US |
Practice Address - Phone: | 636-486-6558 |
Practice Address - Fax: | 636-244-3084 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-06-11 |
Last Update Date: | 2018-06-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Single Specialty |