Melanie Elaine Louis Consolino, LLMSW

Individual provider Active NPI Clinical Social Worker · Vicksburg, MI

NPI 1669139986 · NPPES record last updated Nov 22, 2021

Key facts

NPI: 1669139986
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Social Worker 1041C0700X
License: 6801101824 (MI)
Practice address: 10633 S 27TH St
Vicksburg, MI 49097-9423
Phone: (269) 967-2761
Fax: (269) 552-5586
NPI assigned: Nov 22, 2021
Sex: Female
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

MRC Industries Incorporated Developmentally Disabled Services Day Training Agency · Kalamazoo, MI · NPI 1477500411

NPD

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
6801101824	MI	MD	Clinical Social Worker

Practice roles

Organization	Specialty	Status	New patients
MRC Industries Incorporated		Current since Nov 28, 2021	Accepting new patients

Locations

1606 S Burdick St
Kalamazoo, MI 49001
Phone (269) 343-0747

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Social Worker	1041C0700X	6801101824	MI	Yes

Addresses

Primary practice location

10633 S 27TH St
Vicksburg, MI 49097-9423

Mailing address

1606 S Burdick St
Kalamazoo, MI 49001-2712
Phone (269) 552-3440

Other providers in Vicksburg, MI

All providers in Vicksburg, MI · Clinical Social Worker in Michigan

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.