Provider Demographics
NPI:1235735689
Name:FIELDS, MELANIE (LCSW)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:FIELDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20182 EGYPT RD
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MS
Mailing Address - Zip Code:39730-8519
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20182 EGYPT RD
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MS
Practice Address - Zip Code:39730-8519
Practice Address - Country:US
Practice Address - Phone:469-509-8766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2025-02-06
Deactivation Date:2023-04-14
Deactivation Code:
Reactivation Date:2023-05-03
Provider Licenses
StateLicense IDTaxonomies
TX694551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical