Healthcare Provider Details

I. General information

NPI: 1558826156
Provider Name (Legal Business Name): MELISSA KAY LANGLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2019
Last Update Date: 02/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1371 PEACHTREE HILLS RD
SPRING HOPE NC
27882-8813
US

IV. Provider business mailing address

1371 PEACHTREE HILLS RD
SPRING HOPE NC
27882-8813
US

V. Phone/Fax

Practice location:
  • Phone: 252-904-2206
  • Fax:
Mailing address:
  • Phone: 252-904-2206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberA8921
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: