Provider Demographics
NPI:1265224547
Name:NEIHOF, MELISSA LYNN (LLC, LLMFT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LYNN
Last Name:NEIHOF
Suffix:
Gender:F
Credentials:LLC, LLMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3115 LAPEER RD
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-7309
Mailing Address - Country:US
Mailing Address - Phone:810-300-6771
Mailing Address - Fax:
Practice Address - Street 1:3115 LAPEER RD
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-7309
Practice Address - Country:US
Practice Address - Phone:810-672-6417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451023791101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional