Provider Demographics
NPI:1346461662
Name:TRUAN, MELINDA LANE (MED, LPC)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:LANE
Last Name:TRUAN
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1265 CRESCENTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-2451
Mailing Address - Country:US
Mailing Address - Phone:404-288-4854
Mailing Address - Fax:
Practice Address - Street 1:4501 CIRCLE 75 PKWY SE
Practice Address - Street 2:BLDG. E, SUITE 5220
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-3025
Practice Address - Country:US
Practice Address - Phone:404-274-0282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional