Provider Demographics
NPI:1225835150
Name:STINE, MELISSA LINDSEY KEPLEY (MSW, LCSWA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LINDSEY KEPLEY
Last Name:STINE
Suffix:
Gender:
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:LINDSEY
Other - Last Name:KEPLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSWA
Mailing Address - Street 1:325 CAMERON DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-7967
Mailing Address - Country:US
Mailing Address - Phone:757-439-2515
Mailing Address - Fax:
Practice Address - Street 1:915 VANDORA SPRINGS RD
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-3543
Practice Address - Country:US
Practice Address - Phone:919-283-3302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP021823101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301903HMedicaid