Provider Demographics
NPI:1851313910
Name:LOVE, MELESA (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MELESA
Middle Name:
Last Name:LOVE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-6402
Mailing Address - Country:US
Mailing Address - Phone:931-490-1500
Mailing Address - Fax:931-490-1502
Practice Address - Street 1:1222 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-6402
Practice Address - Country:US
Practice Address - Phone:931-490-1500
Practice Address - Fax:931-490-1502
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN58941041C0700X
IN3400524A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical