Basic Information
| Provider Information | |||||||||
| NPI: | 1528731221 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EDWARDS | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.ED.; NCC; LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5149 S SHADES CREST RD | ||||||||
| Address2: | |||||||||
| City: | HELENA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350224218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053175941 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1600 7TH AVE S | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352331711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2056389100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2021 | ||||||||
| LastUpdateDate: | 07/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 4137 | AL | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.