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General NPI Number Information
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NPI Number | 1629903331
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Entity Type | Individual
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Provider Name | MELLONIE ANDERSON CSAC
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Gender | Female
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Dates
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Enumeration Date | 06/15/2026
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Last Update Date | 06/15/2026
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Provider Practice Location Address
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Address Line | 319 5TH AVE
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City | SALTVILLE
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State | VA
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Zip | 24370-3418
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Country | US
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Telephone | 276-496-4492
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Fax | 276-496-0057
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Provider Business Mailing Address
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Address Line | PO BOX 297
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City | MEADOWVIEW
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State | VA
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Zip | 24361-0297
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Country | US
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Telephone | 276-496-4492
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Fax | 276-496-0057
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0710101833
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License Number State | VA
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