Theresa M Melnychenko
Psychologist Clinical Social Worker
680 Professional Dr
Northfield
, Minnesota 55057-2755
Theresa M Melnychenko
Psychologist Clinical Social Worker
680 Professional Dr
Northfield
, Minnesota 55057-2755
(612) 262-4194
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About
Features
Specialties
- Psychologist
- Clinical Social Worker
Languages spoken
- English
Location
First Address
- Theresa M Melnychenko
- Po Box 43 Mr 10809
- Minneapolis, MN
- Zip : 55440-0043
- Fax : (612) 262-4194
- Phone : (612) 262-4813
Second Address
- Theresa M Melnychenko
- 680 Professional Dr
- Northfield, MN
- Zip : 55057-2755
- Fax : (507) 663-1180
- Phone : (507) 663-0237
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 102L00000X | Psychologist | LP0950 | MN |
| N | 103T00000X | Psychologist | LP0950 | MN |
| N | 1041C0700X | Clinical Social Worker | 7804 | MN |
National Provider Identifier
| NPI | 1013970888 |
|---|---|
| Provider Name | Theresa M Melnychenko |
| First Address | Minneapolis, MN 55440-0043 |
| Second Address | Northfield, MN 55057-2755 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/04/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| OTH000 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.