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NPI Code Detail

MEDICARE: MRS. MELANE CHILDRESS BARBER LCAS

MEDICARE: MRS. MELANE CHILDRESS BARBER LCAS
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
1101YA0400XAddiction (Substance Use Disorder) CounselorLCAS-23295NC

General Provider Information

NPI Number : 1427584333
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELANE CHILDRESS BARBER LCAS
Provider Business Mailing Address
First Line : 200 NORTHVIEW PLZ
Second Line :
City : NORTH WILKESBORO
State : NC
Zip : 28659-3173
Country : US
Telephone Number : 336-818-0607
Fax Number : 336-838-0156
Provider Business Practice Location Address
First Line : 200 NORTHVIEW PLZ
Second Line :
City : NORTH WILKESBORO
State : NC
Zip : 28659-3173
Country : US
Telephone Number : 336-818-0607
Fax Number : 336-838-0156
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2017
Last Update Date : 05/11/2017

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