Provider Demographics
NPI:1730242587
Name:WEHR, MELISSA J (LISW)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:J
Last Name:WEHR
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 PRAIRIE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:IA
Mailing Address - Zip Code:52228-9502
Mailing Address - Country:US
Mailing Address - Phone:319-551-7992
Mailing Address - Fax:
Practice Address - Street 1:1221 PARK PLACE NE
Practice Address - Street 2:SUITE G4
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-2002
Practice Address - Country:US
Practice Address - Phone:319-551-7992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA062241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA38468OtherWELLMARK
IA249547OtherMIDLAND'S CHOICE