Provider Demographics
NPI:1548509573
Name:MADDEN SCHLEGEL, MELISSA (MA, RMHCI)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:MADDEN SCHLEGEL
Suffix:
Gender:F
Credentials:MA, RMHCI
Other - Prefix:
Other - First Name:MISSY
Other - Middle Name:
Other - Last Name:MADDEN-SCHLEGEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, RMHCI
Mailing Address - Street 1:1009 MAITLAND CENTER COMMONS BLVD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7270
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1009 MAITLAND CENTER COMMONS BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7270
Practice Address - Country:US
Practice Address - Phone:407-636-3532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-12
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
FLIMH8344101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No172V00000XOther Service ProvidersCommunity Health Worker