Provider Demographics
NPI:1972916260
Name:HAMILTON, MELISSA (MS, LPC, LCAS)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MS, LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9226 WOODSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:BAILEY
Mailing Address - State:NC
Mailing Address - Zip Code:27807-9268
Mailing Address - Country:US
Mailing Address - Phone:252-230-1452
Mailing Address - Fax:
Practice Address - Street 1:3709 NASH ST NW
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-1127
Practice Address - Country:US
Practice Address - Phone:252-206-5799
Practice Address - Fax:252-206-5778
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-04
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-20677101YA0400X
NC11348101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC20677OtherNC SUBSTANCE ABUSE PROFESSIONAL PRACTICE BOARD
NC11348OtherLICENSED PROFESSIONAL COUNSELOR