Provider Demographics
NPI:1336282177
Name:WOODARD, MELANIE NOE (LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:NOE
Last Name:WOODARD
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E NORTHWOOD ST
Mailing Address - Street 2:SUITE 508
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1224
Mailing Address - Country:US
Mailing Address - Phone:336-275-9889
Mailing Address - Fax:336-275-9880
Practice Address - Street 1:200 E NORTHWOOD ST
Practice Address - Street 2:SUITE 508
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1224
Practice Address - Country:US
Practice Address - Phone:336-275-9889
Practice Address - Fax:336-275-9880
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3417101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102235Medicaid