Provider Demographics
NPI:1467778043
Name:GUARNACCIA, MELISSA JORDAN (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:JORDAN
Last Name:GUARNACCIA
Suffix:
Gender:F
Credentials:MSW, LCSW
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Other - First Name:
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Mailing Address - Street 1:3541 RANDOLPH ROAD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-1009
Mailing Address - Country:US
Mailing Address - Phone:704-381-8360
Mailing Address - Fax:704-381-8832
Practice Address - Street 1:3541 RANDOLPH ROAD
Practice Address - Street 2:SUITE 206
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1009
Practice Address - Country:US
Practice Address - Phone:704-381-8360
Practice Address - Fax:704-381-8832
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCC0066181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical