Melissa S Chancellor

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

134327 Issued in WI

Practice address

1095 Midway Rd
Menasha, WI 54952-1115

Phone

(920) 720-2300

NPI assigned

Jan 12, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1083984637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-720-2300",
            "fax_number": "920-720-3719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 MIDWAY RD",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521115",
            "telephone_number": "920-720-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "459 E 1st St",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549354505",
            "country_code": "US",
            "telephone_number": "920-929-3568",
            "fax_number": "920-929-3129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANCELLOR",
        "first_name": "MELISSA",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-12",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "15413-132",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "134327",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "134327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Cary, LPC-IT
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• Center for Family Healing, Inc.
• Robert Richard Chabalowski, DDS
• La Chang, APNP
• Jennifer Chartier, LPN
• Melissa Lynn Chavas, MSW CAPSW
• Theresa L Chinnery, PHD
• Reegan Chisholm

• Clinical Social Worker in Menasha, WI
• Providers in Menasha, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.