Healthcare Provider Details

I. General information

NPI: 1316071038
Provider Name (Legal Business Name): MELISSA MURRAY SIMPSON NCC, LPCS, LCAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 03/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 EMPEROR BLVD STE. 200
DURHAM NC
27703-8577
US

IV. Provider business mailing address

4600 EMPEROR BLVD STE. 200
DURHAM NC
27703-8577
US

V. Phone/Fax

Practice location:
  • Phone: 919-651-8685
  • Fax: 919-651-8685
Mailing address:
  • Phone: 919-651-8685
  • Fax: 919-651-8685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1314
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5277
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: