Provider Demographics
NPI:1366636185
Name:MEKITA, MELISSA JOHANNA
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:JOHANNA
Last Name:MEKITA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 THREE OAKS DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-2879
Mailing Address - Country:US
Mailing Address - Phone:336-345-6574
Mailing Address - Fax:
Practice Address - Street 1:1208 EASTCHESTER DR STE 112
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-3167
Practice Address - Country:US
Practice Address - Phone:336-471-3946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6104190Medicaid