Provider Demographics
NPI:1720456213
Name:COLE, MELANIE (LPC, NCC, ED D)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:
Last Name:COLE
Suffix:
Gender:F
Credentials:LPC, NCC, ED D
Other - Prefix:MISS
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:MARTINICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4040 MEMORIAL PKWY SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-4364
Mailing Address - Country:US
Mailing Address - Phone:256-533-1970
Mailing Address - Fax:256-705-6477
Practice Address - Street 1:209 CEDAR SPRINGS PL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-3624
Practice Address - Country:US
Practice Address - Phone:409-502-0398
Practice Address - Fax:256-600-8186
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-14
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC2458A101YM0800X
AL8724101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL330000014Medicaid