Provider Demographics
NPI:1033738869
Name:FLANNERY, MELODY MEEKS (MS, LCMHCA, LCAS, CR)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:MEEKS
Last Name:FLANNERY
Suffix:
Gender:F
Credentials:MS, LCMHCA, LCAS, CR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6226 HOLDENS CROSS RD
Mailing Address - Street 2:
Mailing Address - City:STANTONSBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27883-9317
Mailing Address - Country:US
Mailing Address - Phone:252-230-2991
Mailing Address - Fax:252-237-3098
Practice Address - Street 1:6226 HOLDENS CROSS RD
Practice Address - Street 2:
Practice Address - City:STANTONSBURG
Practice Address - State:NC
Practice Address - Zip Code:27883-9317
Practice Address - Country:US
Practice Address - Phone:252-230-2991
Practice Address - Fax:252-237-3098
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-12
Last Update Date:2020-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14291101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health