Individual
MELODY NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCMHCA, NCC
Contact information
Practice address
5540 CENTERVIEW DR, STE 204 #586505, RALEIGH, NC 27606-8012
(336) 422-0768
Mailing address
5540 CENTERVIEW DR, STE 204 #586505, RALEIGH, NC 27606-8012
(336) 422-0768
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700892478
NATIONAL PROVIDER IDENTIFIER (NPI)
NC
Enumeration date
01/16/2023
Last updated
08/31/2024
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