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Provider Information for 1245976471


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MELISSA BYERLEY LCSW


Sex: Female

NPI: 1245976471
Last Updated: 2022-05-10
Certification Date: 2022-05-02

Details

NameValue
NPI1245976471
Enumeration Date2022-05-10
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 3868 S MCDOUGAL ST
BLOOMINGTON, IN 47403-4677
United States

Phone: 317-500-0057 | Fax:
 
Primary Practice Address 3868 S MCDOUGAL ST
BLOOMINGTON, IN 47403-4677
United States

Phone: 317-500-0057 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other URL
Byerley.behavioral@gmail.com
email
Direct CSV 3868 S McDougal St
Bloomington, IN 47403-4677
United States
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalIN34006707A