MEDICARE: MELISSA FAISON LCMHCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	15427	NC

General Provider Information

NPI Number	:	1487285318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA FAISON LCMHCA

Provider Business Mailing Address
First Line	:	204 MUIRS CHAPEL RD STE 136
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-6173
Country	:	US
Telephone Number	:	336-962-6200
Fax Number	:	336-604-0028

Provider Business Practice Location Address
First Line	:	204 MUIRS CHAPEL RD STE 136
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-6173
Country	:	US
Telephone Number	:	336-962-6200
Fax Number	:	336-604-0028

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2020
Last Update Date	:	04/06/2026

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