Provider Demographics
NPI:1083891048
Name:MCSHAN, MELANEY DAVIS- (LPC)
Entity Type:Individual
Prefix:MS
First Name:MELANEY
Middle Name:DAVIS-
Last Name:MCSHAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 FOWLKES ST
Mailing Address - Street 2:
Mailing Address - City:SEALY
Mailing Address - State:TX
Mailing Address - Zip Code:77474-2727
Mailing Address - Country:US
Mailing Address - Phone:979-885-7392
Mailing Address - Fax:979-885-3400
Practice Address - Street 1:240 BELLE ST
Practice Address - Street 2:
Practice Address - City:SEALY
Practice Address - State:TX
Practice Address - Zip Code:77474-2727
Practice Address - Country:US
Practice Address - Phone:979-885-2400
Practice Address - Fax:979-885-3400
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12959101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional