Provider Demographics
NPI:1568160638
Name:MELTON, ANTONIO FRANCHOT (LPCA)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:FRANCHOT
Last Name:MELTON
Suffix:
Gender:M
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3316 BLACKFORD PKWY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-9070
Mailing Address - Country:US
Mailing Address - Phone:859-285-8808
Mailing Address - Fax:
Practice Address - Street 1:3316 BLACKFORD PKWY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-9070
Practice Address - Country:US
Practice Address - Phone:859-559-2483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY278521101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health