Basic Information
| Provider Information | |||||||||
| NPI: | 1881170173 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOLLADA | ||||||||
| FirstName: | MELISSA | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8404 BARNES RD | ||||||||
| Address2: | |||||||||
| City: | VERMILION | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440899563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192396976 | ||||||||
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| Practice Location | |||||||||
| Address1: | 130 SHADY LANE DR | ||||||||
| Address2: | |||||||||
| City: | NORWALK | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448572710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5675603584 | ||||||||
| FaxNumber: | 4195575179 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2018 | ||||||||
| LastUpdateDate: | 04/21/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | C.1902055 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.