Provider Demographics
NPI:1316360605
Name:MULLINEAUX, MELISSA NOEL (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:NOEL
Last Name:MULLINEAUX
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5420 KLEE MILL RD S STE 6
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-9230
Mailing Address - Country:US
Mailing Address - Phone:240-285-4291
Mailing Address - Fax:
Practice Address - Street 1:5420 KLEE MILL RD S STE 6
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-9230
Practice Address - Country:US
Practice Address - Phone:240-285-4261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-23
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5327101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional