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NPI Code Detail

MEDICARE: EDDIE C. MELTON LPC

MEDICARE: EDDIE C. MELTON 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 Counselor2001025452MO

General Provider Information

NPI Number : 1679579353
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDDIE C. MELTON LPC
Provider Business Mailing Address
First Line : PO BOX 14462
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65814-0462
Country : US
Telephone Number : 417-581-4849
Fax Number : 417-581-4839
Provider Business Practice Location Address
First Line : 4699 N 21ST ST
Second Line :
City : OZARK
State : MO
Zip : 65721-7684
Country : US
Telephone Number : 417-258-1484
Fax Number : 417-581-4839
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 07/08/2007

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Directions to “ EDDIE C. MELTON LPC” Practice Location

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