Provider Demographics
NPI:1164835948
Name:STATON, MELINDA (LPC)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:STATON
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 1:2488 GRAND CONCOURSE RM 417
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-5206
Mailing Address - Country:US
Mailing Address - Phone:718-584-7204
Mailing Address - Fax:718-584-8394
Practice Address - Street 1:1030 LOFTIS BLVD STE 102
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2999
Practice Address - Country:US
Practice Address - Phone:571-934-3936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701014609101YP2500X
VA0704013933101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional