Provider Demographics
NPI:1952791485
Name:REID, MELODY BURROUGHS (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MELODY
Middle Name:BURROUGHS
Last Name:REID
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 1:253 BRAMLETT RD
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-7656
Mailing Address - Country:US
Mailing Address - Phone:864-430-6420
Mailing Address - Fax:
Practice Address - Street 1:253 BRAMLETT RD
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-7656
Practice Address - Country:US
Practice Address - Phone:864-430-6420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5793101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional