Provider Demographics
NPI:1790573863
Name:HILL, MELISSA BROOKE (LCMHCA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:BROOKE
Last Name:HILL
Suffix:
Gender:
Credentials:LCMHCA
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:BROOKE
Other - Last Name:KENWORTHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 YELVERTON GROVE RD
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-7401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1319 N BRIGHTLEAF BLVD STE F
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4876
Practice Address - Country:US
Practice Address - Phone:919-934-1312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21124101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health