Provider Demographics
NPI:1063224178
Name:SIMMONS, MELANIE YVETTE (MBA, DBA)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:YVETTE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:MBA, DBA
Other - Prefix:DR
Other - First Name:MELANIE
Other - Middle Name:YVETTE
Other - Last Name:SIMMONS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MBA, DBA
Mailing Address - Street 1:5013 LASSITER MILL RD
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27205-8015
Mailing Address - Country:US
Mailing Address - Phone:980-348-8406
Mailing Address - Fax:
Practice Address - Street 1:5013 LASSITER MILL RD
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27205-8015
Practice Address - Country:US
Practice Address - Phone:980-348-8406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-24
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No171W00000XOther Service ProvidersContractor
No172V00000XOther Service ProvidersCommunity Health Worker
No174H00000XOther Service ProvidersHealth Educator
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider