Provider Demographics
NPI:1619308053
Name:NORD, MELISSA M (LMHC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:M
Last Name:NORD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 NE 16TH ST
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-4147
Mailing Address - Country:US
Mailing Address - Phone:515-635-5016
Mailing Address - Fax:
Practice Address - Street 1:1609 N ANKENY BLVD STE 120
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4112
Practice Address - Country:US
Practice Address - Phone:515-635-5016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-11
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001724101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health