Provider Demographics
NPI:1063460574
Name:MELTON, LYNN T (LMSW)
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:T
Last Name:MELTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:LYNN
Other - Middle Name:T
Other - Last Name:TURBEVILLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:215 N MAGNOLIA ST
Mailing Address - Street 2:SWCMHC
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4943
Mailing Address - Country:US
Mailing Address - Phone:803-775-9364
Mailing Address - Fax:803-773-6615
Practice Address - Street 1:1175 N GUIGNARD DR
Practice Address - Street 2:SWCMHC/CAF
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-1519
Practice Address - Country:US
Practice Address - Phone:803-775-7898
Practice Address - Fax:803-773-5246
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC87104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ33757Medicare UPIN