Provider Demographics
NPI:1477991826
Name:MERLICH SOMERVILLE, MELANIE A (PHD, LPC-S)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:A
Last Name:MERLICH SOMERVILLE
Suffix:
Gender:F
Credentials:PHD, LPC-S
Other - Prefix:MS
Other - First Name:MELANIE
Other - Middle Name:A
Other - Last Name:SOMERVILLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, LPC-S
Mailing Address - Street 1:5555 FREDERICKSBURG RD
Mailing Address - Street 2:#102
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3500
Mailing Address - Country:US
Mailing Address - Phone:210-616-0828
Mailing Address - Fax:210-616-0829
Practice Address - Street 1:1905 ELDER HILL RD
Practice Address - Street 2:
Practice Address - City:DRIFTWOOD
Practice Address - State:TX
Practice Address - Zip Code:78619
Practice Address - Country:US
Practice Address - Phone:512-842-6767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional