Healthcare Provider Details

I. General information

NPI: 1871362715
Provider Name (Legal Business Name): MELISSA PAINTER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2023
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 438
CROWDER MS
38622-0438
US

IV. Provider business mailing address

PO BOX 438
CROWDER MS
38622-0438
US

V. Phone/Fax

Practice location:
  • Phone: 662-339-3088
  • Fax:
Mailing address:
  • Phone: 662-339-3088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH27372
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMI-0000196
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number068.0136912
License Number StateVT
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2720
License Number StateMS
# 5
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5371786
License Number StateID
# 6
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0024563
License Number StateCO
# 7
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1535
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: