Provider Demographics
NPI:1730648270
Name:SUTTON, MELISSA SUE (MA LPC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:SUE
Last Name:SUTTON
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:SUE
Other - Last Name:RUSSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA ALC
Mailing Address - Street 1:6900 HIGHWAY 81
Mailing Address - Street 2:
Mailing Address - City:PHIL CAMPBELL
Mailing Address - State:AL
Mailing Address - Zip Code:35581-6030
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 4TH AVE S
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-3705
Practice Address - Country:US
Practice Address - Phone:205-530-3358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3143101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health