MEDICARE: MELISSA BEDDINGFIELD LPC

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	101YP2500X	Professional Counselor	4866	NC
2	101YP2500X	Professional Counselor	4968	SC
3	101YP2500X	Professional Counselor	005766	GA

General Provider Information

NPI Number	:	1760644421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA BEDDINGFIELD LPC

Provider Business Mailing Address
First Line	:	710 HUDSON WAY
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30076-8507
Country	:	US
Telephone Number	:	404-642-5099
Fax Number	:	404-855-3993

Provider Business Practice Location Address
First Line	:	6065 LAKE FORREST DR STE 170
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-3844
Country	:	US
Telephone Number	:	404-642-5099
Fax Number	:	404-855-3993

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

Provider Enumeration Date	:	06/25/2008
Last Update Date	:	04/12/2024

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Directions to “ MELISSA BEDDINGFIELD LPC” Practice Location

Language	Start Address	Practice Location

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