Individual
MR. MELVIN THOMAS NORMAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA/LADAC2/QCS/NCAC1/
Contact information
Practice address
119 RACINE ST STE 105, MEMPHIS, TN 38111-2729
(901) 230-4047
(901) 443-5089
Mailing address
119 RACINE ST STE 103, MEMPHIS, TN 38111-2729
(901) 230-4047
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LDC0000000722
TN
101YM0800X
Mental Health Counselor
722
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
054462778
—
TN
Enumeration date
11/28/2017
Last updated
04/15/2019
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