Collingsworth, Melissa

Collingsworth, Melissa is an individual health care provider with primary practice located at 909 E State Blvd , Fort Wayne IN 46805-3404. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Collingsworth, Melissa can be contacted via phone (260) 481-2700.

Contact Information

Primary practice address
909 E State Blvd Fort Wayne IN 46805-3404
Phone: (260) 481-2700
Fax: (260) 481-2709
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 33007721A Indiana
Behavioral Health & Social Service Providers / Clinical 1041C0700X 34009112A Indiana
Behavioral Health & Social Service Providers / Counselor 101Y00000X

Profile Details

NPI number 1588061592
LBN Legal business name Collingsworth, Melissa
Credentials MSW, LCSW
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 20th, 2014
Last updated Sep 13th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588061592 NPPES
Indiana Other 34009112A INDIANA BEHAVIORAL HEALTH BOARD

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