Provider Demographics
NPI:1861065047
Name:AMADOR, MELISSA NICOLE
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:NICOLE
Last Name:AMADOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 ESTELLE CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-5180
Mailing Address - Country:US
Mailing Address - Phone:919-257-1301
Mailing Address - Fax:
Practice Address - Street 1:2020 CHAPEL HILL RD STE 23
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-1186
Practice Address - Country:US
Practice Address - Phone:919-688-7101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0164211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical