Provider Demographics
NPI:1780842740
Name:THOMPSON, MELODY M (LPC)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:M
Last Name:THOMPSON
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 1:222 N LAFAYETTE ST
Mailing Address - Street 2:SUITE 02
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-4444
Mailing Address - Country:US
Mailing Address - Phone:704-482-2460
Mailing Address - Fax:704-487-5950
Practice Address - Street 1:222 N LAFAYETTE ST
Practice Address - Street 2:SUITE 02
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-4444
Practice Address - Country:US
Practice Address - Phone:704-482-2460
Practice Address - Fax:704-487-5950
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1041C0700XOtherTAXONOMY