Provider Demographics
NPI:1205663978
Name:MELVIN, ELVIRA P (MAHS)
Entity type:Individual
Prefix:MS
First Name:ELVIRA
Middle Name:P
Last Name:MELVIN
Suffix:
Gender:F
Credentials:MAHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 WISTERIA RD
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-3495
Mailing Address - Country:US
Mailing Address - Phone:843-797-7871
Mailing Address - Fax:
Practice Address - Street 1:96 WISTERIA RD
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-3495
Practice Address - Country:US
Practice Address - Phone:843-797-7871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)