Provider Demographics
NPI:1932817616
Name:MARION, MELISSA FOSTER (MA, LCMHCA)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:FOSTER
Last Name:MARION
Suffix:
Gender:F
Credentials:MA, LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 WALNUT DR
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27205-9497
Mailing Address - Country:US
Mailing Address - Phone:336-465-3178
Mailing Address - Fax:
Practice Address - Street 1:330 WALNUT DR
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27205-9497
Practice Address - Country:US
Practice Address - Phone:336-465-3178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17721101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health