Provider Demographics
NPI:1962864983
Name:CLAUDIA MELTON, INC
Entity Type:Organization
Organization Name:CLAUDIA MELTON, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPSIT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:BALLENGER
Authorized Official - Last Name:MELTON
Authorized Official - Suffix:
Authorized Official - Credentials:MS/EDS, LPC
Authorized Official - Phone:336-848-1999
Mailing Address - Street 1:117 W WHITE DR
Mailing Address - Street 2:
Mailing Address - City:ARCHDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27263-2853
Mailing Address - Country:US
Mailing Address - Phone:336-848-1999
Mailing Address - Fax:336-949-5885
Practice Address - Street 1:117 W WHITE DR
Practice Address - Street 2:
Practice Address - City:ARCHDALE
Practice Address - State:NC
Practice Address - Zip Code:27263-2853
Practice Address - Country:US
Practice Address - Phone:336-848-1999
Practice Address - Fax:336-949-5885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3333101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC610253Medicaid