Provider Demographics
NPI:1457372088
Name:PASCHAL, MELANIE COBLE (LCSW)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:COBLE
Last Name:PASCHAL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:D
Other - Last Name:COBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2 TERRACE WAY
Mailing Address - Street 2:STE D
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-3663
Mailing Address - Country:US
Mailing Address - Phone:336-617-7337
Mailing Address - Fax:336-464-2932
Practice Address - Street 1:2872 YOUTH UNLIMITED DR
Practice Address - Street 2:
Practice Address - City:SOPHIA
Practice Address - State:NC
Practice Address - Zip Code:27350-8460
Practice Address - Country:US
Practice Address - Phone:336-861-6380
Practice Address - Fax:336-861-1417
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6003574Medicaid
NC6003574Medicaid