Provider Demographics
NPI:1417421389
Name:LI, MELISSA VICTORIA (MS, LPC INTERN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:VICTORIA
Last Name:LI
Suffix:
Gender:F
Credentials:MS, LPC INTERN
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:VICTORIA
Other - Last Name:STOKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC INTERN
Mailing Address - Street 1:320 WESTWAY PL
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-5245
Mailing Address - Country:US
Mailing Address - Phone:817-516-9100
Mailing Address - Fax:817-516-9102
Practice Address - Street 1:320 WESTWAY PL
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-5245
Practice Address - Country:US
Practice Address - Phone:817-516-9100
Practice Address - Fax:817-516-9102
Is Sole Proprietor?:No
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor