Provider Demographics
NPI:1679124390
Name:SINGLETON, MELONIE GRACE (LCSW)
Entity type:Individual
Prefix:
First Name:MELONIE
Middle Name:GRACE
Last Name:SINGLETON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 RIVER RUN RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:GA
Mailing Address - Zip Code:30656-7205
Mailing Address - Country:US
Mailing Address - Phone:404-977-1583
Mailing Address - Fax:
Practice Address - Street 1:125 W ATHENS ST
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-1710
Practice Address - Country:US
Practice Address - Phone:706-521-3113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-24
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW008912101YM0800X
GACSW0082641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health