Provider Demographics
NPI:1417296765
Name:NORMAN, MELANIE ROSE (LCMHC, LCAS)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:ROSE
Last Name:NORMAN
Suffix:
Gender:F
Credentials:LCMHC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 MELODY LN
Mailing Address - Street 2:
Mailing Address - City:MAGGIE VALLEY
Mailing Address - State:NC
Mailing Address - Zip Code:28751-9613
Mailing Address - Country:US
Mailing Address - Phone:828-507-1739
Mailing Address - Fax:
Practice Address - Street 1:28 WALNUT ST STE 4
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-3246
Practice Address - Country:US
Practice Address - Phone:828-507-1739
Practice Address - Fax:828-333-4288
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2509101YA0400X
NC7807101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health