Provider Demographics
NPI:1962216150
Name:SHOEMAKER, MELISSA (LCMHCA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SHOEMAKER
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 ROCK LANE DR
Mailing Address - Street 2:
Mailing Address - City:DOBSON
Mailing Address - State:NC
Mailing Address - Zip Code:27017-8205
Mailing Address - Country:US
Mailing Address - Phone:336-466-4921
Mailing Address - Fax:
Practice Address - Street 1:314 WINSTON RD
Practice Address - Street 2:
Practice Address - City:JONESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28642-2214
Practice Address - Country:US
Practice Address - Phone:336-818-0733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21071101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health