Melanie Beverely Roberts-Fuston, LCSW

Individual provider Active NPI Clinical Social Worker · Whiteman Air Force Base, MO

NPI 1154450955 · NPPES record last updated Jun 14, 2019

Key facts

NPI
1154450955
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
6801098656 (MI)
Practice address
331 Sijan Ave
Whiteman Air Force Base, MO 65305-1269
Phone
(660) 687-4341
Fax
(660) 687-5256
NPI assigned
Mar 5, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801098656 MI Yes

Addresses

Primary practice location

331 Sijan Ave
Whiteman Air Force Base, MO 65305-1269

Mailing address

6290 Bailey Rd
Eau Claire, MI 49111-9654
Phone (575) 361-4844

Other providers in Whiteman Air Force Base, MO

All providers in Whiteman Air Force Base, MO · Clinical Social Worker in Missouri

Sources for this page

Verify at the official NPI Registry.