MEDICARE: MELISSA G DOBBINS 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
1	101YM0800X	Mental Health Counselor	10640	NC

General Provider Information

NPI Number	:	1720266000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA G DOBBINS LPC

Provider Business Mailing Address
First Line	:	960 SHASTA DAISY DR
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-3956
Country	:	US
Telephone Number	:	817-874-1175
Fax Number	:

Provider Business Practice Location Address
First Line	:	7000 HARPS MILL RD
Second Line	:	STE. 102
City	:	RALEIGH
State	:	NC
Zip	:	27615-3239
Country	:	US
Telephone Number	:	919-617-9656
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2008
Last Update Date	:	06/12/2014

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