Provider Demographics
NPI:1336291046
Name:ENSLEY, MELINDA ANNE (LPC)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:ANNE
Last Name:ENSLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:ANNE
Other - Last Name:ENSELY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NCC, LPC-S LMFT
Mailing Address - Street 1:7301 FOREST AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3792
Mailing Address - Country:US
Mailing Address - Phone:804-570-7941
Mailing Address - Fax:804-447-8204
Practice Address - Street 1:7301 FOREST AVE STE 200
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3792
Practice Address - Country:US
Practice Address - Phone:804-570-7941
Practice Address - Fax:804-447-8204
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701012313101YP2500X
LA2452101YP2500X
KY271319101YP2500X
LA292106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist