Provider Demographics
NPI:1548066426
Name:MELENDEZ, ANDREW RAY
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:RAY
Last Name:MELENDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9679 W QUARTER MOON DR
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:IN
Mailing Address - Zip Code:46064-9464
Mailing Address - Country:US
Mailing Address - Phone:765-617-2889
Mailing Address - Fax:
Practice Address - Street 1:10291 N MERIDIAN ST STE 250
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46290-0002
Practice Address - Country:US
Practice Address - Phone:317-755-6321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker