Provider Demographics
NPI:1164627287
Name:GANN, MELANIE GAYLE (LPC-S)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:GAYLE
Last Name:GANN
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:MS
Other - First Name:MELANIE
Other - Middle Name:GAYLE
Other - Last Name:CHESSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBS, LPC
Mailing Address - Street 1:1008 MERCURY DR
Mailing Address - Street 2:
Mailing Address - City:LAVON
Mailing Address - State:TX
Mailing Address - Zip Code:75166-1870
Mailing Address - Country:US
Mailing Address - Phone:580-795-4485
Mailing Address - Fax:580-795-7444
Practice Address - Street 1:7308 ALMA DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-3568
Practice Address - Country:US
Practice Address - Phone:972-422-5939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67302101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional