Active NPI
Michele A. Melvin, EDS, LCPC
- Professional Counselor
- Champaign, IL
National Provider Identifier
1184755449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180003314
- Practice address
- 908 Trailway Dr
Champaign, IL 61822-2080 - Phone
- (217) 607-1600
- NPI assigned
- Mar 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180003314 | IL | Primary |
Addresses
Primary practice location
908 Trailway Dr
Champaign, IL 61822-2080
Mailing address
908 Trailway Dr
Champaign, IL 61822-2080
Phone (217) 607-1600
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01522514 | Other | IL | BCBS PROVIDER # |
| 180003314 | Other | IL | LCPC # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180003314 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209081600000",
"number": "1184755449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "908 TRAILWAY DR",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618222080",
"telephone_number": "217-607-1600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "908 TRAILWAY DR",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618222080",
"telephone_number": "217-607-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELVIN",
"first_name": "MICHELE",
"middle_name": "A.",
"name_prefix": "Mrs.",
"credential": "EDS, LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2008-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180003314",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER #",
"identifier": "01522514",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCPC #",
"identifier": "180003314",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.