| Doctor Name: | MELANIE RENEE PRIVAT |
| NPI Number: | 1003203076 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC, LAC |
| License Number: | 2059 |
| Business Practice Address: | 4105 W 6th St Suite B4 Lawrence, KS - 660494609 |
| Business Phone Number: | 7852183229 |
| Business Fax Number: | 7858321445 |
| Mailing Address: | 4105 W 6th St Suite B4, LAWRENCE |
| State: | KS |
| Postal Code: | 66049 |
| Phone Number: | 7852183229 |
| Fax Number: | 7858321445 |
| NPI Enumeration Date: | 04/17/2015 |
| NPI Last Update Date: | 04/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2059 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |