Melissa Johanna Spencer, LPC
Individual provider Active NPI Specialist · Fairmont, NC
NPI 1508990979 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1508990979
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 3727 (NC)
- Practice address
- 302 N Main St
Fairmont, NC 28340-1730 - Phone
- (910) 628-6718
- Fax
- (910) 628-6719
- NPI assigned
- Mar 15, 2007
- 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 |
|---|---|---|---|
| 3727 | NC | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 3727 | NC | Yes |
Addresses
Primary practice location
302 N Main St
Fairmont, NC 28340-1730
Mailing address
PO Box 369
Fairmont, NC 28340-0369
Phone (910) 628-6718
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6102694 | Medicaid | NC |
Other providers in Fairmont, NC
- Shawn'S Home Care LLC
- South Robeson Rescue Unit Incorporated
- Southeastern Psychological Services
- Southeastern Regional Medical Center
- Southeastern Regional Physician Services
- Sprouting Therapy Services, PLLC
- Stephens Outreach Center, Inc
- Stephens Outreach Center, Inc
- Joshua David Sumner
- Tarheel Developmental Therapy Services, Inc.
All providers in Fairmont, NC · Specialist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.