Provider Demographics
NPI:1972255974
Name:INNOCENZI, MELISSA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:INNOCENZI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:ESSIAMBRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:748 ROGERS RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-7636
Mailing Address - Country:US
Mailing Address - Phone:818-324-8135
Mailing Address - Fax:
Practice Address - Street 1:748 ROGERS RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-7636
Practice Address - Country:US
Practice Address - Phone:818-324-8135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38641106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist