Provider Demographics
NPI:1871516872
Name:DEAS, MELISSA JOLEEN (LPC, CAC II)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:JOLEEN
Last Name:DEAS
Suffix:
Gender:F
Credentials:LPC, CAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1321 LADY STREET, 1ST FLOOR
Mailing Address - Street 2:PALMETTO HEALTH
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201
Mailing Address - Country:US
Mailing Address - Phone:803-296-2548
Mailing Address - Fax:803-296-2525
Practice Address - Street 1:1330 TAYLOR @ MARION STREET
Practice Address - Street 2:PALMETTO BAPTIST COUNSELING CENTER
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201
Practice Address - Country:US
Practice Address - Phone:803-296-2548
Practice Address - Fax:803-296-2525
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0410156101YA0400X
SC3799101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional