Provider Demographics
NPI:1609092402
Name:BEAIRD, MELISSA MICKLE (LPC, CEAP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:MICKLE
Last Name:BEAIRD
Suffix:
Gender:F
Credentials:LPC, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 LAKESHORE DR
Mailing Address - Street 2:SUITE 212
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6729
Mailing Address - Country:US
Mailing Address - Phone:205-879-7500
Mailing Address - Fax:
Practice Address - Street 1:2204 LAKESHORE DR
Practice Address - Street 2:SUITE 212
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6729
Practice Address - Country:US
Practice Address - Phone:205-879-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1983101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional