Provider Demographics
NPI:1700575933
Name:SNODGRASS, MELISSA MARY (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:MARY
Last Name:SNODGRASS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8334 PINEVILLE MATTHEWS RD STE 103-146
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-3774
Mailing Address - Country:US
Mailing Address - Phone:704-756-7566
Mailing Address - Fax:
Practice Address - Street 1:8334 PINEVILLE MATTHEWS RD STE 103-146
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3774
Practice Address - Country:US
Practice Address - Phone:704-756-7566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-03
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0168701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical