Provider Demographics
NPI:1578104121
Name:WELDON, MELODIE (LMHC)
Entity Type:Individual
Prefix:
First Name:MELODIE
Middle Name:
Last Name:WELDON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 ST. MARKS PLACE
Mailing Address - Street 2:
Mailing Address - City:MT. KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10543
Mailing Address - Country:US
Mailing Address - Phone:914-242-7606
Mailing Address - Fax:
Practice Address - Street 1:33 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-1603
Practice Address - Country:US
Practice Address - Phone:845-473-5952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009697-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health