Provider Demographics
NPI:1649094087
Name:DOLIN, MELONIE SUE (LPC, NCC)
Entity type:Individual
Prefix:
First Name:MELONIE
Middle Name:SUE
Last Name:DOLIN
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 HARMONS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:POCA
Mailing Address - State:WV
Mailing Address - Zip Code:25159-9089
Mailing Address - Country:US
Mailing Address - Phone:304-951-2487
Mailing Address - Fax:
Practice Address - Street 1:509 HARMONS CREEK RD
Practice Address - Street 2:
Practice Address - City:POCA
Practice Address - State:WV
Practice Address - Zip Code:25159-9089
Practice Address - Country:US
Practice Address - Phone:304-951-2487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV101YS0200X
WV3030101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool