Provider Demographics
NPI:1548767122
Name:WINSTON, MELISSA ANN (LMFT)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANN
Last Name:WINSTON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 SW EAGLES PKWY
Mailing Address - Street 2:
Mailing Address - City:GRAIN VALLEY
Mailing Address - State:MO
Mailing Address - Zip Code:64029-8508
Mailing Address - Country:US
Mailing Address - Phone:816-443-5279
Mailing Address - Fax:816-443-5279
Practice Address - Street 1:1406 SW EAGLES PKWY
Practice Address - Street 2:
Practice Address - City:GRAIN VALLEY
Practice Address - State:MO
Practice Address - Zip Code:64029-8508
Practice Address - Country:US
Practice Address - Phone:816-443-5279
Practice Address - Fax:916-443-5279
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-10
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014025253106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist