Provider Demographics
NPI:1386388932
Name:PATTERSON, MELISA (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:MELISA
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 RIDGECREST DR
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28081-9589
Mailing Address - Country:US
Mailing Address - Phone:704-223-1506
Mailing Address - Fax:
Practice Address - Street 1:207 RIDGECREST DR
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28081-9589
Practice Address - Country:US
Practice Address - Phone:704-223-1506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0146771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical