MEDICARE: MRS. MELINDA S COMPTON LPC LICDC QMHS

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	LICDC.162475	OH
2	172V00000X	Community Health Worker		OH
3	101YP2500X	Professional Counselor	C.2506834	OH

General Provider Information

NPI Number	:	1881360600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELINDA S COMPTON LPC LICDC QMHS

Provider Business Mailing Address
First Line	:	434 EASTLAND RD
Second Line	:
City	:	BEREA
State	:	OH
Zip	:	44017-1217
Country	:	US
Telephone Number	:	440-234-2006
Fax Number	:

Provider Business Practice Location Address
First Line	:	4579 EVERHARD RD NW STE A
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44718-2425
Country	:	US
Telephone Number	:	440-260-6466
Fax Number	:

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

Provider Enumeration Date	:	08/20/2021
Last Update Date	:	02/03/2025

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