Provider Information for 1184219776
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Mrs. MELISSA DAWN HENRY LPC, LCMHC
Sex: Female
NPI: 1184219776
Last Updated: 2024-08-09
Certification Date: 2024-08-09
Certification Date: 2024-08-09
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1184219776 | ||||||||||||
| Enumeration Date | 2021-03-04 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 901 W CHURCH ST ELIZABETH CITY, NC 27909-4629 United States Phone: 757-581-1898 | Fax: | ||||||||||||
| Primary Practice Address | 901 W CHURCH ST ELIZABETH CITY, NC 27909-4629 United States Phone: 978-768-8744 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 505 S INDEPENDENCE BLVD STE 213 | ||||||||||||
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