Provider Demographics
NPI:1356119465
Name:ROBINS, MELINDA LOUEZIA (LPC)
Entity type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:LOUEZIA
Last Name:ROBINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:MELINDA
Other - Middle Name:FLETCHER
Other - Last Name:ROBINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:110 RIGGS CIR
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-9015
Mailing Address - Country:US
Mailing Address - Phone:912-486-4238
Mailing Address - Fax:
Practice Address - Street 1:110 RIGGS CIR
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-9015
Practice Address - Country:US
Practice Address - Phone:912-486-4238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007344101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health