Provider Demographics
NPI:1538571286
Name:BROWN, MELODY A (LPCC)
Entity type:Individual
Prefix:
First Name:MELODY
Middle Name:A
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5335 FAR HILLS AVE STE 211
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-2317
Mailing Address - Country:US
Mailing Address - Phone:937-287-1566
Mailing Address - Fax:
Practice Address - Street 1:5335 FAR HILLS AVE STE 211
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-2317
Practice Address - Country:US
Practice Address - Phone:937-287-1566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-29
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1400017101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0074861OtherMEDICAID LEGACY NUMBER CHEMICAL DEPENDENCY
OH0074946OtherMEDICAID LEGACY NUMBER MENTAL HEALTH