Provider Demographics
NPI:1952168882
Name:WARD, MELANIE (LPC A)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:LPC A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 EAST MCBEE AVE STE 100
Mailing Address - Street 2:#1116
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-4939
Mailing Address - Country:US
Mailing Address - Phone:954-804-9068
Mailing Address - Fax:
Practice Address - Street 1:500 EAST MCBEE AVE STE 100
Practice Address - Street 2:#1116
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601
Practice Address - Country:US
Practice Address - Phone:864-251-5079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCCOU.8889101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor