Provider Demographics
NPI:1497817266
Name:HENDRIX, MELBA DUBOSE (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:MELBA
Middle Name:DUBOSE
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 HORNER ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-3433
Mailing Address - Country:US
Mailing Address - Phone:540-347-0708
Mailing Address - Fax:540-347-7972
Practice Address - Street 1:35 HORNER ST
Practice Address - Street 2:SUITE 100
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-3433
Practice Address - Country:US
Practice Address - Phone:540-347-0708
Practice Address - Fax:540-347-7972
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1377101YP2500X
VA0132106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist