Provider Demographics
NPI:1750820973
Name:MUZZUPAPPA, MELISSA MARIE (LISW-CP, LCSW-C, MSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:MUZZUPAPPA
Suffix:
Gender:F
Credentials:LISW-CP, LCSW-C, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 21ST AVE N STE 17
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-7496
Mailing Address - Country:US
Mailing Address - Phone:843-868-6200
Mailing Address - Fax:843-868-6200
Practice Address - Street 1:1551 21ST AVE N STE 17
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-7496
Practice Address - Country:US
Practice Address - Phone:843-868-6200
Practice Address - Fax:843-868-6200
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-21
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC135351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty