Provider Demographics
NPI:1295095529
Name:LAYTON, MELANIA XIOMARA (LCAS, CSI)
Entity type:Individual
Prefix:
First Name:MELANIA
Middle Name:XIOMARA
Last Name:LAYTON
Suffix:
Gender:F
Credentials:LCAS, CSI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 DANSEY CIRCLE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713
Mailing Address - Country:US
Mailing Address - Phone:919-328-9350
Mailing Address - Fax:877-525-4498
Practice Address - Street 1:2530 MERIDIAN PKWY STE 300
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-5273
Practice Address - Country:US
Practice Address - Phone:919-328-9350
Practice Address - Fax:877-525-4498
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2351A101Y00000X, 101YA0400X, 251B00000X
NC2351101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6112391Medicaid