Provider Demographics
NPI:1699816462
Name:VANN, MELISSA C (LPC)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:C
Last Name:VANN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 PROVIDENCE MAIN ST.
Mailing Address - Street 2:SUITE 303E
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806
Mailing Address - Country:US
Mailing Address - Phone:256-797-5492
Mailing Address - Fax:256-551-0722
Practice Address - Street 1:475 PROVIDENCE MAIN ST.
Practice Address - Street 2:SUITE 303E
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806
Practice Address - Country:US
Practice Address - Phone:256-797-5492
Practice Address - Fax:256-551-0722
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2488101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional