MELINDA KAY PETTIT NPI 1437605342

NPI Information

NPI: 1437605342
Provider Name: MELINDA KAY PETTIT
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
104 JORDAN PLAZA BLVD
SUITE 402-403
TYLER, TX
ZIP 75704
Phone: (903) 581-9472
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Melinda Kay Pettit is an addiction (substance use disorder) counselor in Tyler, TX. Melinda Kay Pettit NPI is 1437605342. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

104 JORDAN PLAZA BLVD
SUITE 402-403
TYLER, TX
ZIP 75704-055
Phone: (903) 581-9472

The enumeration date for this NPI number is 8/31/2016 and was last updated on 8/31/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	12348	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	12348	OTHER	TEXAS	LCDC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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