Active NPI
Harold Melancon, LPC
- Professional Counselor
- Vicksburg, MS
National Provider Identifier
1043766884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1055
- Practice address
- 1414 Cherry St
Vicksburg, MS 39180-3218 - Phone
- (601) 636-5703
- Fax
- (601) 636-5739
- NPI assigned
- Aug 31, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1055 | MS | Primary |
Addresses
Primary practice location
1414 Cherry St
Vicksburg, MS 39180-3218
Mailing address
45 Woodgate Dr
Brandon, MS 39042-2285
Phone (601) 831-4133
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1055 | MS | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grace Christian Counseling Center | Professional | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Marriage & Family Therapist
- Vicksburg, MS
- NPI 1447295654
Professional
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472601600000",
"number": "1043766884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 WOODGATE DR",
"city": "BRANDON",
"state": "MS",
"postal_code": "390422285",
"telephone_number": "601-831-4133",
"fax_number": "601-636-5739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1414 CHERRY ST",
"city": "VICKSBURG",
"state": "MS",
"postal_code": "391803218",
"telephone_number": "601-636-5703",
"fax_number": "601-636-5739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELANCON",
"first_name": "HAROLD",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-08-31",
"last_updated": "2016-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MS",
"license": "1055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vicksburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.