Provider Demographics
NPI:1588616270
Name:BROWN, MELINDA COLLETT (LCSW, CHWC)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:COLLETT
Last Name:BROWN
Suffix:
Gender:
Credentials:LCSW, CHWC
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:S
Other - Last Name:COLLETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW, CHWC
Mailing Address - Street 1:153 S COLONIAL AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-3517
Mailing Address - Country:US
Mailing Address - Phone:804-675-5000
Mailing Address - Fax:
Practice Address - Street 1:1200 BROAD ROCK RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23249-1433
Practice Address - Country:US
Practice Address - Phone:804-675-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33271041C0700X
161790171400000X
VA09040175591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171400000XOther Service ProvidersHealth & Wellness Coach
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3327OtherLICENSED CLINICAL SOCIAL WORKER
161790OtherCERTIFIED HEALTH AND WELLBEING COACH: WELLCOACHES CORPORATION
VA0904017559OtherLCSW