=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538656194
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MELISSA NICOLE BRATTER LCMHC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/19/2018
-----------------------------------------------------
Last Update Date | 01/15/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14 CHAMBERS DR
-----------------------------------------------------
City | WEAVERVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28787-9602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-414-8669
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14 CHAMBERS DR
-----------------------------------------------------
City | WEAVERVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28787-9602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-414-8669
-----------------------------------------------------
Fax | 828-259-5384
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 13775
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------