Provider Demographics
NPI:1588938781
Name:FRED MELOWSKY, PHD, INC
Entity type:Organization
Organization Name:FRED MELOWSKY, PHD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:MELOWSKY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:513-621-5001
Mailing Address - Street 1:26 E HOLLISTER STREET
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-1107
Mailing Address - Country:US
Mailing Address - Phone:513-621-5001
Mailing Address - Fax:513-621-5008
Practice Address - Street 1:26 E. HOLLISTER STREET
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-1107
Practice Address - Country:US
Practice Address - Phone:513-621-5001
Practice Address - Fax:513-621-5008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty