Provider Demographics
NPI:1538273248
Name:KELTGEN, MELISSA MAE (MS LAMFT NCC LPC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MAE
Last Name:KELTGEN
Suffix:
Gender:F
Credentials:MS LAMFT NCC LPC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:MAE
Other - Last Name:BATESON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1407 S STATE STREET
Mailing Address - Street 2:
Mailing Address - City:NEW ULM
Mailing Address - State:MN
Mailing Address - Zip Code:56073
Mailing Address - Country:US
Mailing Address - Phone:507-354-3181
Mailing Address - Fax:507-354-3183
Practice Address - Street 1:1407 S STATE STREET
Practice Address - Street 2:
Practice Address - City:NEW ULM
Practice Address - State:MN
Practice Address - Zip Code:56073
Practice Address - Country:US
Practice Address - Phone:507-354-3181
Practice Address - Fax:507-354-3183
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00328101YP2500X
MN1523106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist