Provider Demographics
NPI:1548902174
Name:NIBERT, MELISSA DAWN (MSW, LSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:DAWN
Last Name:NIBERT
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ASPIRE FAMILY WELLNESS
Mailing Address - Street 2:7121 CRAB CREEK RD.
Mailing Address - City:GALLIPOLISFERRY
Mailing Address - State:WV
Mailing Address - Zip Code:25515
Mailing Address - Country:US
Mailing Address - Phone:304-593-6109
Mailing Address - Fax:
Practice Address - Street 1:738 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-1056
Practice Address - Country:US
Practice Address - Phone:304-208-0215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAP00944765104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty