Melisa Marcelle Carrico, LCPC

Individual provider Active NPI Professional Counselor · Oakland, MD

NPI 1801912282 · NPPES record last updated Dec 16, 2010

Key facts

NPI
1801912282
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
LC1331 (MD)
Practice address
315 Dawson Ave Ste C
Oakland, MD 21550-5113
Phone
(240) 321-2487
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LC1331MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Skyeia Holistic Services, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC1331 MD Yes

Addresses

Primary practice location

315 Dawson Ave Ste C
Oakland, MD 21550-5113

Mailing address

1138 Eagle Rock Rd
Oakland, MD 21550-6825
Phone (240) 321-2487

Other identifiers

IdentifierTypeStateIssuer
012466400MedicaidMD

Other names

  • Melisa M Miner Former name

Other providers in Oakland, MD

All providers in Oakland, MD · Professional Counselor in Maryland

Sources for this page

Verify at the official NPI Registry.