Provider Demographics
NPI: | 1053066670 |
---|---|
Name: | RODRIGUEZ GALEANO, MELANY (MA, LPC, LCMHC) |
Entity Type: | Individual |
Prefix: | |
First Name: | MELANY |
Middle Name: | |
Last Name: | RODRIGUEZ GALEANO |
Suffix: | |
Gender: | F |
Credentials: | MA, LPC, LCMHC |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 1 CARRIAGE LN |
Mailing Address - Street 2: | BUILDING E, SUITE 202 |
Mailing Address - City: | CHARLESTON |
Mailing Address - State: | SC |
Mailing Address - Zip Code: | 29407-5865 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 843-256-4327 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1 CARRIAGE LN |
Practice Address - Street 2: | BUILDING E, SUITE 202 |
Practice Address - City: | CHARLESTON |
Practice Address - State: | SC |
Practice Address - Zip Code: | 29407-5865 |
Practice Address - Country: | US |
Practice Address - Phone: | 843-256-4327 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2022-02-14 |
Last Update Date: | 2024-03-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
SC | 9321 | 101YP2500X, 101Y00000X |
SC | 7868 | 101YM0800X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health |
Yes | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional |
No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor |