Melina Marie Sample, PHD, HSPP - Psychologist in Mishawaka, IN

Melina Marie Sample, PHD, HSPP is a Psychologist - Clinical based in Mishawaka, Indiana. Melina Marie Sample is licensed to practice in Indiana (license number 20043242A) and her current practice location is 210 S Race St, Mishawaka, Indiana. She can be reached at her office (for appointments etc.) via phone at (574) 404-6755.

NPI number for Melina Marie Sample is 1861049595 and her current mailing address is 2709 Blacktail Ct, South Bend, Indiana. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1861049595.

Contact Information

Melina Marie Sample, PHD, HSPP
210 S Race St,
Mishawaka, IN 46544-2032
(574) 404-6755
(833) 783-4269

Map and Direction




Healthcare Provider's Profile

Full NameMelina Marie Sample
GenderFemale
SpecialityPsychologist - Clinical
Location210 S Race St, Mishawaka, Indiana
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1861049595
  • Provider Enumeration Date: 08/19/2019
  • Last Update Date: 08/19/2019

Medical Identifiers

Medical identifiers for Melina Marie Sample such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1861049595NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical 20043242A (Indiana)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Melina Marie Sample is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Melina Marie Sample, PHD, HSPP
2709 Blacktail Ct,
South Bend, IN 46614-9168

Ph: (574) 274-8193
Melina Marie Sample, PHD, HSPP
210 S Race St,
Mishawaka, IN 46544-2032

Ph: (574) 404-6755

Reviews and Comments


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