Provider Demographics
NPI:1659434553
Name:DOBSON, MELISSA D (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:D
Last Name:DOBSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12770 COUNTY ROAD 121
Mailing Address - Street 2:
Mailing Address - City:BRYCEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32009-1317
Mailing Address - Country:US
Mailing Address - Phone:904-553-5883
Mailing Address - Fax:
Practice Address - Street 1:12770 COUNTY ROAD 121
Practice Address - Street 2:
Practice Address - City:BRYCEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32009-1317
Practice Address - Country:US
Practice Address - Phone:904-553-5883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 7465101YM0800X
FLMH10744101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL767189000Medicaid