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Provider Information for 1386338598


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MELISSA BRUNSON LPC


Sex: Female

NPI: 1386338598
Last Updated: 2023-06-08
Certification Date: 2023-06-08

Details

NameValue
NPI1386338598
Enumeration Date2023-06-08
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 2008 NORTHERLY WAY
STONE MOUNTAIN, GA 30088-4309
United States

Phone: 678-231-5990 | Fax:
 
Primary Practice Address 2008 NORTHERLY WAY
STONE MOUNTAIN, GA 30088-4309
United States

Phone: 678-231-5990 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental Health