ANGELA MELLACE (NPI# 1558790436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558790436 |
| Entity Type | Individual |
| Full Name | ANGELA MELLACE |
| Practice Address |
212 North Court Street Wayne WV 25570 |
| Practice Telephone | 3045296205 |
| Practice Fax Number | 3045296209 |
| Mailing Telephone | 3045296205 |
| Mailing Fax Number | 3045296209 |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2013-11-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
F362604 | WV | Behavioral Health & Social Service Providers |
| Street Address |
212 NORTH COURT STREET |
| City | WAYNE |
| State | WV |
| Zip Code | 25570 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093992299 | Leslie Nicole Parker | Occupational Therapist | 212 North Court Street, Wayne, WV 25570 | 2008-01-30 |
| 1992946701 | Christine Sanders Kelly | Speech-Language Pathologist | 212 North Court Street, Wayne, WV 25570 | 2009-03-09 |
| 1679742621 | Wayne County Board of Education | Local Education Agency (LEA) | 212 North Court Street, Wayne, WV 25570-0070 | 2008-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710586532 | Stephanie Michelle Turley | Technician | 207 Mary Davis Branch Road, Wayne, WV 25570 | 2020-10-22 |
| 1508463332 | Cheyann Marie White | Technician | 1317 Left Fork Wilson Creek Road, Wayne, WV 25570 | 2020-10-05 |
| 1619582483 | Joanna Wiley | Technician | 612 Wayne Street, Wayne, WV 25570 | 2020-09-09 |
| 1568076859 | Betty Perry | Technician | 3745 Big Branch Rd, Wayne, WV 25570 | 2020-09-03 |
| 1497367106 | Summer Susanna Bias | Technician | 150 Mose Asbury Road, Wayne, WV 25570 | 2020-08-24 |
| 1508475070 | Donnetta Sue Pratt | Case Manager/Care Coordinator | 1066 Little Lynn Creek Road, Wayne, WV 25570 | 2020-07-30 |
| 1508333659 | Tami Renee Harless | Technician | 112 Riverside Drive Dunrovin Estates, Wayne, WV 25570 | 2018-10-26 |
| 1457867137 | Sarah Minnie Skeens | Technician | 1030 Wilson Creek Road, Wayne, WV 25570 | 2017-12-18 |
| 1497261234 | Zelma Rae Toler | Technician | 112 Riverside Drive, Dunrovan Estate, Wayne, WV 25570 | 2017-12-15 |
| 1639684012 | Patricia Sue Adkins | Technician | 881 Toms Crk Rd, Wayne, WV 25570 | 2017-12-07 |
| Find all providers in zip 25570 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417590589 | Jessica Serene Martin | Psychologist | 212 N Court St, Wayne, WV 25570-1141 | 2019-10-22 |
| 1285280081 | Kelsey Ross | Psychologist | 212 N Court St, Wayne, WV 25570-1141 | 2019-08-16 |
| 1386192235 | Alexandria Mejia | Psychologist | 212 N Court St, Office of Special Programs, Wayne, WV 25570-1141 | 2016-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790317782 | Preston Dyer Modlin | Psychologist | 635 Church Street, Lewisburg, WV 24901 | 2020-02-07 |
| 1124570957 | Katie Hamm | Psychologist | 50 Underwood Cir, Mount Zion, WV 26151-8556 | 2016-10-27 |
| 1669922092 | Jonathan Shank | Psychologist | 813 Capitol St, Spencer, WV 25276-1924 | 2016-10-10 |
| 1255881082 | Lisha Tignor | Psychologist | 98 Carter Braxton Dr, Sutton, WV 26601-9592 | 2016-10-05 |
| 1437606068 | Tiffany Yancey | Psychologist | 197 Chestnut Street, Greenbrier County Schools, Lewisburg, WV 24901 | 2016-09-01 |
| 1831645647 | Rachel Hendricks | Psychologist | 400 Old Main Drive, Nicholas County Schools, Summersville, WV 26651 | 2016-08-31 |
| 1811355597 | New Beginnings Therapy Services, LLC | Psychologist | 220 S Walker St Ste A, Princeton, WV 24740-2747 | 2016-02-09 |
| 1104291681 | Ashley Booten | Psychologist | 501 22nd St, Dunbar, WV 25064-1711 | 2015-12-09 |
| 1871998500 | Natalie Campbell | Psychologist | 275 Business Park Dr., Kenna, WV 25248 | 2014-10-23 |
| 1669875738 | Joe Testa | Psychologist | 34 Dorothy Ave, Wheeling, WV 26003-5217 | 2014-10-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.