Provider Demographics
NPI:1548428378
Name:DOERFER, MELISSA ANN (MS/EDS,LCMHC,NCC,CHT)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANN
Last Name:DOERFER
Suffix:
Gender:F
Credentials:MS/EDS,LCMHC,NCC,CHT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:DOERFER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS/EDS,LCMHC,NCC,CHT
Mailing Address - Street 1:453 W END BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-1120
Mailing Address - Country:US
Mailing Address - Phone:336-750-0706
Mailing Address - Fax:
Practice Address - Street 1:453 W END BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-1120
Practice Address - Country:US
Practice Address - Phone:336-750-0706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7223101YP2500X
NCLPC 7223101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional