Provider Demographics
NPI:1497326433
Name:HOUCK, MELISSA KATLYN (LGPC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:KATLYN
Last Name:HOUCK
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 TANEY DR
Mailing Address - Street 2:
Mailing Address - City:TANEYTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21787-2234
Mailing Address - Country:US
Mailing Address - Phone:301-254-2127
Mailing Address - Fax:
Practice Address - Street 1:425 TANEY DR
Practice Address - Street 2:
Practice Address - City:TANEYTOWN
Practice Address - State:MD
Practice Address - Zip Code:21787-2234
Practice Address - Country:US
Practice Address - Phone:301-254-2127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP11550101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional