Provider Demographics
NPI:1083012488
Name:WOODBY, MELISSA WELLS (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:WELLS
Last Name:WOODBY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:WELLS
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:8704 PLEASANT HILL RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37924-3211
Mailing Address - Country:US
Mailing Address - Phone:865-724-7817
Mailing Address - Fax:
Practice Address - Street 1:6305 LONAS DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909
Practice Address - Country:US
Practice Address - Phone:865-588-3173
Practice Address - Fax:865-588-3174
Is Sole Proprietor?:No
Enumeration Date:2014-12-17
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1312106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist