Provider Demographics
NPI:1821752106
Name:WALSON, MELISA (LCSWA)
Entity Type:Individual
Prefix:MS
First Name:MELISA
Middle Name:
Last Name:WALSON
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 WOODLAKE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-5968
Mailing Address - Country:US
Mailing Address - Phone:336-686-1937
Mailing Address - Fax:
Practice Address - Street 1:913 WOODLAKE DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-5968
Practice Address - Country:US
Practice Address - Phone:336-686-1937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-24
Last Update Date:2021-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0160291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical