Provider Demographics
NPI:1952595951
Name:MULLINS, MELISSA M (LPC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:M
Last Name:MULLINS
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 1:10906 FEATHERBROOK RD APT 2C
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-7732
Mailing Address - Country:US
Mailing Address - Phone:704-208-8013
Mailing Address - Fax:
Practice Address - Street 1:1501 MAIN ST STE 140
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-5801
Practice Address - Country:US
Practice Address - Phone:704-208-8013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-01
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7871101YP2500X
SC6176101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional