Provider Demographics
NPI:1871564542
Name:SMITH, MELANIE MARIA (LPC)
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:MARIA
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4800 N SCOTTSDALE RD STE 2500
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-7630
Mailing Address - Country:US
Mailing Address - Phone:636-681-2620
Mailing Address - Fax:
Practice Address - Street 1:16020 SWINGLEY RIDGE RD STE 300
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-2085
Practice Address - Country:US
Practice Address - Phone:636-681-2620
Practice Address - Fax:636-933-3510
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001031173101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO498315803Medicaid