Melissa Bordelon Shields, LPC
Individual provider Active NPI Professional Counselor · Brandon, MS
NPI 1134528516 · NPPES record last updated Aug 21, 2014
Key facts
- NPI
- 1134528516
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 1912 (MS)
- Practice address
- 613 Marquette Rd
Brandon, MS 39042-3038 - Phone
- (601) 825-8800
- Fax
- (601) 824-0349
- NPI assigned
- Aug 21, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1912 | MS | Yes |
Addresses
Primary practice location
613 Marquette Rd
Brandon, MS 39042-3038
Mailing address
PO Box 88
Brandon, MS 39043-0088
Phone (601) 825-8800
Other providers in Brandon, MS
- Bleigh Incorporated
- Kiessha Body
- Terrell Lane Boler
- Sandra J Bonom
- Ritha G Bookert
- Merikelly Borgognoni
- Lyinka Nicole Boston
- Boudreaux Mental Health Services
- Lindsey Ferguson Bounds
- Jonathan Gaston Box
All providers in Brandon, MS · Professional Counselor in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.