Provider Demographics
NPI:1447947510
Name:CARSON, MELISSA LYNN (LPC)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:LYNN
Last Name:CARSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11573 MARY LEE DR
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-7049
Mailing Address - Country:US
Mailing Address - Phone:225-788-8411
Mailing Address - Fax:
Practice Address - Street 1:30665 N WALKER RD
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:LA
Practice Address - Zip Code:70785-5602
Practice Address - Country:US
Practice Address - Phone:225-788-8411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8239101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor