Provider Demographics
NPI:1881359735
Name:MELTON, BOBBIE SHAE (LPC)
Entity type:Individual
Prefix:
First Name:BOBBIE
Middle Name:SHAE
Last Name:MELTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1067 FM 306 STE 402
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-6895
Mailing Address - Country:US
Mailing Address - Phone:512-537-1353
Mailing Address - Fax:
Practice Address - Street 1:1067 FM 306 STE 402
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-6895
Practice Address - Country:US
Practice Address - Phone:512-537-1353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-05
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84044101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional