Provider Demographics
NPI:1770997082
Name:SYMONDS, MELISSA DAWN (LPC)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:DAWN
Last Name:SYMONDS
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 1:15 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06412-1201
Mailing Address - Country:US
Mailing Address - Phone:860-227-2843
Mailing Address - Fax:
Practice Address - Street 1:15 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:CT
Practice Address - Zip Code:06412-1201
Practice Address - Country:US
Practice Address - Phone:860-227-2843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-13
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID5562101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health