MELISSA LYNN PEDERSON MALADC NPI 1154096378

NPI Information

NPI: 1154096378
Provider Name: MELISSA LYNN PEDERSON, MA,LADC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
4615 GRAND AVE STE 300
DULUTH, MN
ZIP 55807
Phone: (218) 282-2174
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Melissa Lynn Pederson, MA,LADC is an addiction (substance use disorder) counselor in Duluth, MN. Melissa Lynn Pederson, MA,LADC NPI is 1154096378. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4615 GRAND AVE STE 300
DULUTH, MN
ZIP 55807-749
Phone: (218) 282-2174
Fax: (218) 600-5485

The enumeration date for this NPI number is 8/10/2021 and was last updated on 8/10/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	305465	MINNESOTA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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