Provider Demographics
NPI:1437483567
Name:BECK, MELISSA QUEEN HARGETT (PHD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:QUEEN HARGETT
Last Name:BECK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10140 PROVIDENCE CHURCH LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-9722
Mailing Address - Country:US
Mailing Address - Phone:980-297-2763
Mailing Address - Fax:704-846-9424
Practice Address - Street 1:10140 PROVIDENCE CHURCH LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-9722
Practice Address - Country:US
Practice Address - Phone:980-297-2763
Practice Address - Fax:704-846-9424
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3528103T00000X, 103TH0004X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool