Provider Demographics
NPI:1356745335
Name:ENOCH, MELISSA (LPC, LCAS, CCS, MAC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ENOCH
Suffix:
Gender:F
Credentials:LPC, LCAS, CCS, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 HOLLY HILL LN STE 102E
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-5197
Mailing Address - Country:US
Mailing Address - Phone:336-270-4053
Mailing Address - Fax:704-333-2447
Practice Address - Street 1:5820 E WT HARRIS BLVD STE 120
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-3604
Practice Address - Country:US
Practice Address - Phone:704-333-2447
Practice Address - Fax:704-333-2447
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-20
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20613101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health