Provider Demographics
NPI:1700163110
Name:BROWN, MELISSA MACKIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:MACKIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2415 MORGANTON BLVD. SW
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645
Mailing Address - Country:US
Mailing Address - Phone:828-652-2919
Mailing Address - Fax:828-394-5418
Practice Address - Street 1:2415 MORGANTON BLVD SW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-9691
Practice Address - Country:US
Practice Address - Phone:828-652-2919
Practice Address - Fax:828-394-5418
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0002571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical