Provider Demographics
NPI:1972167542
Name:GOLDSTEIN, MELISSA (LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 PIEDMONT RD NE STE 350
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1582
Mailing Address - Country:US
Mailing Address - Phone:804-512-5302
Mailing Address - Fax:404-351-0243
Practice Address - Street 1:3520 PIEDMONT RD NE STE 350
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1582
Practice Address - Country:US
Practice Address - Phone:804-512-5302
Practice Address - Fax:404-351-0243
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007146101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health