Provider Demographics
NPI:1316491723
Name:PLUE, MELINDA CAMPBELL (MSW, LCSW-A)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:CAMPBELL
Last Name:PLUE
Suffix:
Gender:F
Credentials:MSW, LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 WINCHESTER AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-3040
Mailing Address - Country:US
Mailing Address - Phone:704-877-9881
Mailing Address - Fax:
Practice Address - Street 1:124 WINCHESTER AVE STE B
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-3040
Practice Address - Country:US
Practice Address - Phone:704-877-9881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0096211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical