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General NPI Number Information
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NPI Number | 1780515668
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Entity Type | Individual
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Provider Name | MELISSA PHILLIPS WILSON LPC
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Gender | Female
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Dates
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Enumeration Date | 05/28/2026
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Last Update Date | 05/28/2026
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Provider Practice Location Address
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Address Line | 599 COUNTY ROAD 570A
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City | EASTLAND
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State | TX
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Zip | 76448-6644
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Country | US
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Telephone | 254-647-3219
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Fax |
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Provider Business Mailing Address
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Address Line | 260 FAIRWAY AVE
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City | EASTLAND
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State | TX
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Zip | 76448-3583
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Country | US
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Telephone | 770-823-2299
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 86274
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License Number State | TX
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