Provider Demographics
NPI:1518786243
Name:JEFFERSON, MELODY L
Entity type:Individual
Prefix:
First Name:MELODY
Middle Name:L
Last Name:JEFFERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELODY
Other - Middle Name:LAYNE
Other - Last Name:HARPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1536
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28680-1536
Mailing Address - Country:US
Mailing Address - Phone:828-437-3000
Mailing Address - Fax:828-437-4999
Practice Address - Street 1:301 E MEETING ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3593
Practice Address - Country:US
Practice Address - Phone:828-437-3000
Practice Address - Fax:828-437-4999
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health