Provider Demographics
NPI:1386687671
Name:MARTIN, MELISSA DAWN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:DAWN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:DAWN
Other - Last Name:SUMMERFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1225 SIXTH AVENUE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-2311
Mailing Address - Country:US
Mailing Address - Phone:304-526-9189
Mailing Address - Fax:304-526-9989
Practice Address - Street 1:1225 SIXTH AVENUE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-2311
Practice Address - Country:US
Practice Address - Phone:304-526-9189
Practice Address - Fax:304-526-9989
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1021101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional