Provider Demographics
NPI:1265272033
Name:HUNT, MELINDA C (LCSWA)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:C
Last Name:HUNT
Suffix:
Gender:X
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 SHAWNEE ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-1352
Mailing Address - Country:US
Mailing Address - Phone:919-656-5608
Mailing Address - Fax:
Practice Address - Street 1:906 BROAD ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4142
Practice Address - Country:US
Practice Address - Phone:910-420-0940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15094225700000X
NCP0206221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist