Provider Demographics
NPI:1639535297
Name:ROGERS, MELISSA HAMMONDS (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:HAMMONDS
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4266 HAYNES LENNON HWY
Mailing Address - Street 2:
Mailing Address - City:CHADBOURN
Mailing Address - State:NC
Mailing Address - Zip Code:28431-6944
Mailing Address - Country:US
Mailing Address - Phone:910-234-0988
Mailing Address - Fax:
Practice Address - Street 1:4266 HAYNES LENNON HWY
Practice Address - Street 2:
Practice Address - City:CHADBOURN
Practice Address - State:NC
Practice Address - Zip Code:28431-6944
Practice Address - Country:US
Practice Address - Phone:910-234-0988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0084971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical