Provider Demographics
NPI:1144837014
Name:EDWARDS, MELLANEY DENISE (MSW, LISW)
Entity type:Individual
Prefix:
First Name:MELLANEY
Middle Name:DENISE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 LANDERBROOK DR STE 300
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-4029
Mailing Address - Country:US
Mailing Address - Phone:216-235-6810
Mailing Address - Fax:
Practice Address - Street 1:5900 LANDERBROOK DR STE 300
Practice Address - Street 2:
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-4029
Practice Address - Country:US
Practice Address - Phone:216-235-6810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-25
Last Update Date:2023-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.23048171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty