1154788644 NPI number — MRS. MELANIE MCKEE STEVENS LPC

Table of content: MRS. MELANIE MCKEE STEVENS LPC (NPI 1154788644)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154788644 NPI number — MRS. MELANIE MCKEE STEVENS LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEVENS
Provider First Name:
MELANIE
Provider Middle Name:
MCKEE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCKEE
Provider Other First Name:
MELANIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1154788644
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/19/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
57340 COMPANY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LORANGER
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70446
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-323-6797
Provider Business Mailing Address Fax Number:
504-780-1705

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
408 EAST OLIVE STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AMITE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70422
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-323-6797
Provider Business Practice Location Address Fax Number:
985-246-2601
Provider Enumeration Date:
01/28/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  LPC 5297 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 5219 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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