Provider Demographics
NPI:1912514555
Name:DUNN, MELISSA-MILES (LPCA)
Entity Type:Individual
Prefix:
First Name:MELISSA-MILES
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ARCADIAN PARK
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7105
Mailing Address - Country:US
Mailing Address - Phone:662-902-3825
Mailing Address - Fax:
Practice Address - Street 1:451 FOLLY RD STE 107
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2640
Practice Address - Country:US
Practice Address - Phone:662-902-3825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7493101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health