Provider Demographics
NPI:1629708789
Name:MEADE, MELISSA (LPC/MHSP-T)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:MEADE
Suffix:
Gender:F
Credentials:LPC/MHSP-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5721 MARLIN RD STE 3800
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-5651
Mailing Address - Country:US
Mailing Address - Phone:423-521-5678
Mailing Address - Fax:
Practice Address - Street 1:5721 MARLIN RD STE 3800
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-5651
Practice Address - Country:US
Practice Address - Phone:423-521-5678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNT-4896101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health