Stefan Tyler Melvin

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P012663 Issued in NC

Practice address

1325 Southpoint Crossing Dr
Durham, NC 27713-6608

Phone

(919) 662-1820

NPI assigned

Jul 10, 2018

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": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1578059887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WAKE FOREST RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096859",
            "telephone_number": "919-865-8856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 SOUTHPOINT CROSSING DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136608",
            "telephone_number": "919-662-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELVIN",
        "first_name": "STEFAN",
        "middle_name": "TYLER",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P012663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric B. Meltzer, MD
• Andrea Antoinette Melvin, RN
• Jeni Erickson Melvin, OTD, OTR/L
• Julieann Melvin
• Latarsha Ford Melvin, MSW, LCSWA
• Brett F. Memauri, MD
• Amber Memory, CNM
• Brandon Michael Menachem, MD
• Marcy Menard, MS, RD, LDN
• Andrea Mendez Colmenares, MD, PHD

• Clinical Social Worker in Durham, NC
• Providers in Durham, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.