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NPI Code Detail

MEDICARE: MRS. MELISSA DAWN MARTIN LPC

MEDICARE: MRS. MELISSA DAWN MARTIN LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor1021WV

General Provider Information

NPI Number : 1386687671
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELISSA DAWN MARTIN LPC
Provider Business Mailing Address
First Line : 1225 SIXTH AVENUE
Second Line :
City : HUNTINGTON
State : WV
Zip : 25701-2311
Country : US
Telephone Number : 304-526-9189
Fax Number : 304-526-9989
Provider Business Practice Location Address
First Line : 1225 SIXTH AVENUE
Second Line :
City : HUNTINGTON
State : WV
Zip : 25701-2311
Country : US
Telephone Number : 304-526-9189
Fax Number : 304-526-9989
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2006
Last Update Date : 07/08/2007

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