Provider Demographics
NPI:1821818162
Name:RAINES, MELISSA AUTUMN (LCMHCA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:AUTUMN
Last Name:RAINES
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N RIDGEWAY AVE
Mailing Address - Street 2:
Mailing Address - City:BLACK MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28711-3506
Mailing Address - Country:US
Mailing Address - Phone:828-669-9798
Mailing Address - Fax:
Practice Address - Street 1:201 N RIDGEWAY AVE
Practice Address - Street 2:
Practice Address - City:BLACK MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28711-3506
Practice Address - Country:US
Practice Address - Phone:828-669-9798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA20664101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional