Melody Carol Fancher
Individual provider Active NPI Mental Health Counselor · Monticello, FL
NPI 1164078689 · NPPES record last updated Mar 31, 2022
Key facts
- NPI
- 1164078689
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- MH19688 (FL)
- Practice address
- 140 Kaptain Dr
Monticello, FL 32344-1199 - Phone
- (850) 491-0979
- NPI assigned
- Aug 12, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMH18527 | FL | MD | Mental Health Counselor |
| MH19688 | FL | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IMH18527 | FL | |
| Mental Health Counselor | 101YM0800X | MH19688 | FL | Yes |
Addresses
Primary practice location
140 Kaptain Dr
Monticello, FL 32344-1199
Mailing address
140 Kaptain Dr
Monticello, FL 32344-1199
Phone (850) 491-0979
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 682280 | Other | FL | NATIONAL BOARD FOR CERTIFIED COUNSELORS, INC. |
Other names
- Carol Shrum Fancher
Other providers in Monticello, FL
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- Expanded Opportunities Outpatient Drug Treatment
- Florida Department of Health
- Shanise Ford
- Shanomia Francis
- Frisby Healthcare Solutions Inc
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All providers in Monticello, FL · Mental Health Counselor in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2022. 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.