Provider Demographics
NPI:1689700544
Name:MCDUFF, MELANIE (LISW-CP)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:MCDUFF
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:VAUGHN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISW-CP
Mailing Address - Street 1:4696 SIDNEYS RD
Mailing Address - Street 2:
Mailing Address - City:WALTERBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29488-9756
Mailing Address - Country:US
Mailing Address - Phone:843-708-4949
Mailing Address - Fax:
Practice Address - Street 1:18 WEDGEFIELD DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2226
Practice Address - Country:US
Practice Address - Phone:828-252-8748
Practice Address - Fax:828-667-5843
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC013145104100000X
1041C0700X
SC82681041C0700X, 106H00000X, 104100000X, 101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC8268OtherSC BOARD OF SOCIAL WORK EXAMINERS