Provider Demographics
NPI:1528294378
Name:SINGHAUS, MELANIE (LSW)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:
Last Name:SINGHAUS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 SECOND ST. N. E.
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44704
Mailing Address - Country:US
Mailing Address - Phone:330-454-7917
Mailing Address - Fax:330-454-1476
Practice Address - Street 1:919 SECOND ST. N. E.
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44704
Practice Address - Country:US
Practice Address - Phone:330-454-7917
Practice Address - Fax:330-454-1476
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS0700531251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0290822Medicaid