Provider Demographics
NPI:1578525192
Name:BROWN, MELISSA J (LPC)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:J
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 GREENWAY LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-7214
Mailing Address - Country:US
Mailing Address - Phone:769-572-2560
Mailing Address - Fax:
Practice Address - Street 1:103 W WASHINGTON ST STE A-2
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-2427
Practice Address - Country:US
Practice Address - Phone:769-572-2560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1630101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional