Provider Demographics
NPI:1336318682
Name:SLOANE, KEISHA MELISSA (LPC, LCMHC)
Entity Type:Individual
Prefix:MS
First Name:KEISHA
Middle Name:MELISSA
Last Name:SLOANE
Suffix:
Gender:F
Credentials:LPC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2257
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27402-2257
Mailing Address - Country:US
Mailing Address - Phone:336-455-3139
Mailing Address - Fax:336-450-1033
Practice Address - Street 1:2302 W MEADOWVIEW RD
Practice Address - Street 2:SUITE 105
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-3706
Practice Address - Country:US
Practice Address - Phone:336-455-3139
Practice Address - Fax:336-450-1033
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6881101YM0800X, 101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor