Provider Demographics
NPI:1205847092
Name:LUVALL, MELANIE ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:ANN
Last Name:LUVALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:ANN
Other - Last Name:RIX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 18084
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35804-8084
Mailing Address - Country:US
Mailing Address - Phone:256-882-2003
Mailing Address - Fax:256-705-4630
Practice Address - Street 1:3007 MEMORIAL PKWY SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5393
Practice Address - Country:US
Practice Address - Phone:256-882-2003
Practice Address - Fax:256-705-4630
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
AL0975C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALR81709Medicare UPIN
AL000042959COXMedicare ID - Type Unspecified