Mary E Melton, PHD, PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1641 Issued in GA

Legal business name

MARY E MELTON, PHD, PC

Practice address

1805 Herrington Rd
#2
Lawrenceville, GA 30043-5649

Phone

(770) 962-1944

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

Mary Melton, PHD

Title

Licensed Psychologist Ceo

Phone

(770) 962-1944

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187740800000",
    "number": "1861513673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 HERRINGTON RD",
            "address_2": "#2",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 HERRINGTON RD",
            "address_2": "#2",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435649",
            "telephone_number": "770-962-1944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY E MELTON, PHD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-08-22",
        "status": "A",
        "authorized_official_last_name": "MELTON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST  CEO",
        "authorized_official_telephone_number": "770-962-1944",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "1641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; 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.