Provider Demographics
NPI:1235623562
Name:TAYLOR, MELISSA VALERIE (MA, PLPC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:VALERIE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MA, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4249 CHOUTEAU AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1753
Mailing Address - Country:US
Mailing Address - Phone:314-403-2031
Mailing Address - Fax:
Practice Address - Street 1:PSYCHOLOGICAL SERVICES OF ST LOUIS, LLC
Practice Address - Street 2:7110 OAKLAND AVE
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117
Practice Address - Country:US
Practice Address - Phone:314-403-2031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health