Provider Demographics
NPI:1164099156
Name:BELL, MELINDA SUE (CADCI)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:SUE
Last Name:BELL
Suffix:
Gender:F
Credentials:CADCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 MORTON ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-5150
Mailing Address - Country:US
Mailing Address - Phone:704-537-7775
Mailing Address - Fax:
Practice Address - Street 1:2225 FREEDOM DR STE 5
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-4035
Practice Address - Country:US
Practice Address - Phone:704-537-7775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCADC-25454101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)