Provider Demographics
NPI:1538277959
Name:WOOD, MELISSA S (MS, LPC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:S
Last Name:WOOD
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:LEVELLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79336-3921
Mailing Address - Country:US
Mailing Address - Phone:806-897-9735
Mailing Address - Fax:806-894-4712
Practice Address - Street 1:1313 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:LEVELLAND
Practice Address - State:TX
Practice Address - Zip Code:79336-3921
Practice Address - Country:US
Practice Address - Phone:806-897-9735
Practice Address - Fax:806-894-4712
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17330101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional