Melvin Walter David Proctor, PCC-S

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E-0002670 Issued in OH

Practice address

2495 W Market St Ste C
Tiffin, OH 44883-8450

Phone

(141) 944-3120

NPI assigned

Feb 8, 2011

Last updated

Feb 8, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297123200000",
    "number": "1255637203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2495 W MARKET ST STE C",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448838450",
            "telephone_number": "141-944-3120",
            "fax_number": "141-944-3152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 W MARKET ST STE C",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448838450",
            "telephone_number": "141-944-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "MELVIN",
        "middle_name": "WALTER DAVID",
        "name_prefix": "Mr.",
        "credential": "PCC-S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-08",
        "last_updated": "2011-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E-0002670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Pothast
• Prasad Choudary Kakarala (Tiffin Pediatrics Associates)
• Preferred Pathways
• Anna Price, SLP
• Krystal Dawn Price, L.M.T.
• Promedica Central Physicians LLC (ProMedica Physicians Eye Care)
• Teresa Province
• Bryce K Pryor
• Cadyia Pugh
• Punita P Kothari

• Mental Health Counselor in Tiffin, OH
• Providers in Tiffin, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.