Provider Demographics
NPI:1861250227
Name:LEWIS, MELANIE YOLANDA (LPC)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:YOLANDA
Last Name:LEWIS
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 1:4152 JARRELLS WAY
Mailing Address - Street 2:
Mailing Address - City:BURR HILL
Mailing Address - State:VA
Mailing Address - Zip Code:22433-9771
Mailing Address - Country:US
Mailing Address - Phone:540-223-1885
Mailing Address - Fax:
Practice Address - Street 1:8000 BROOK RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-1338
Practice Address - Country:US
Practice Address - Phone:804-553-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701012421101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional