Provider Demographics
NPI:1912550971
Name:SMITH, MELISSA P (MMFT, LMFT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:P
Last Name:SMITH
Suffix:
Gender:F
Credentials:MMFT, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 W ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-1606
Mailing Address - Country:US
Mailing Address - Phone:864-238-2618
Mailing Address - Fax:
Practice Address - Street 1:306B W POINSETT ST
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-1548
Practice Address - Country:US
Practice Address - Phone:864-238-2618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4576106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist