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Individual
MELISSA SUE PROCTOR
Active
Individual
MELISSA SUE PROCTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
4948
KY
1041C0700X
Clinical Social Worker
Primary
0904015618
VA
1041C0700X
Clinical Social Worker
62650
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0904015618
COMMONWEALTH OF VIRGINIA
VA
05
—
1336188655
—
KY
01
—
62650
BOARD OF BEHAVIORAL SCIENCES
CA
Enumeration date
06/05/2006
Last updated
06/26/2024
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