Provider Demographics
NPI:1427264787
Name:PILKINTON, MELINDA WALLS (PHD, LCSW, ACSW)
Entity type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:WALLS
Last Name:PILKINTON
Suffix:
Gender:F
Credentials:PHD, LCSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 WILLOWBROOK ROAD
Mailing Address - Street 2:SUITE C
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39703
Mailing Address - Country:US
Mailing Address - Phone:662-244-2560
Mailing Address - Fax:662-244-2575
Practice Address - Street 1:525 WILLOWBROOK RD
Practice Address - Street 2:SUITE C
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-2016
Practice Address - Country:US
Practice Address - Phone:662-244-2560
Practice Address - Fax:662-244-2575
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSLCSW27261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical