=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437974557
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MELANIE MCMILLION, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/22/2024
-----------------------------------------------------
Last Update Date | 11/22/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8571 NW 11TH ST
-----------------------------------------------------
City | CORAL SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33071-7101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 754-778-9028
-----------------------------------------------------
Fax | 754-778-9028
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8571 NW 11TH ST
-----------------------------------------------------
City | CORAL SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33071-7101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-263-0421
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MELANIE MCMILLION
-----------------------------------------------------
Credential | MS, LMHC
-----------------------------------------------------
Telephone | 754-778-9028
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------