Healthcare Provider Details

I. General information

NPI: 1508777699
Provider Name (Legal Business Name): MELINDA DAFFRON LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 SAMS POINT RD
BEAUFORT SC
29907-1588
US

IV. Provider business mailing address

1211 CASSANDER CREEK RD
BEAUFORT SC
29902-5294
US

V. Phone/Fax

Practice location:
  • Phone: 843-953-0015
  • Fax:
Mailing address:
  • Phone: 949-310-4189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11056
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: