Provider Demographics
NPI:1760644421
Name:BEDDINGFIELD, MELISSA (LPC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:BEDDINGFIELD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 HUDSON WAY
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-8507
Mailing Address - Country:US
Mailing Address - Phone:404-642-5099
Mailing Address - Fax:404-855-3993
Practice Address - Street 1:6065 LAKE FORREST DR STE 170
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3844
Practice Address - Country:US
Practice Address - Phone:404-642-5099
Practice Address - Fax:404-855-3993
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4866101YP2500X
SC4968101YP2500X
GA005766101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional