Provider Demographics
NPI:1417902032
Name:CLINGER, MELISSA V (PSY D)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:V
Last Name:CLINGER
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CONCOURSE PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244
Mailing Address - Country:US
Mailing Address - Phone:205-444-0420
Mailing Address - Fax:205-403-0747
Practice Address - Street 1:100 CONCOURSE PKWY STE 101
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35244
Practice Address - Country:US
Practice Address - Phone:205-444-0420
Practice Address - Fax:205-403-0747
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51545494OtherBLUE CROSS
AL51007340OtherBLUE CROSS FED
R63299Medicare UPIN