Individual provider · NPI-1

Melisa Andre Andre, MSW

Counselor, Mental Health · Port St Lucie, FL

NPI number1962083857
StatusActive
Last updated in NPPESJul 18, 2024

Details

NPI
1962083857
Entity type
Individual (NPI-1)
Name
Melisa Andre Andre
Credential
MSW
Sex
Female
Sole proprietor
Yes
Enumeration date
Apr 21, 2021
Certification date
Jul 18, 2024
Last updated
Jul 18, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental Health––Yes
171M00000X Case Manager/Care Coordinator––

Practice location

518 Sw Prima Vista Blvd
Port St Lucie, FL 34983-8734

Phone 772-873-8811 · Fax 772-873-8800

Mailing address

1639 Forum Pl Ste 7
West Palm Beach, FL 33401-2330

Phone 561-712-8821

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