Provider Demographics
NPI:1619220100
Name:RABY, MELISSA LEIGH (MA, MSW, LCSW, CSOTP)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:LEIGH
Last Name:RABY
Suffix:
Gender:F
Credentials:MA, MSW, LCSW, CSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 27
Mailing Address - Street 2:
Mailing Address - City:MC KENNEY
Mailing Address - State:VA
Mailing Address - Zip Code:23872
Mailing Address - Country:US
Mailing Address - Phone:804-478-5006
Mailing Address - Fax:
Practice Address - Street 1:9736 LEW JONES RD
Practice Address - Street 2:
Practice Address - City:MC KENNEY
Practice Address - State:VA
Practice Address - Zip Code:23872-2936
Practice Address - Country:US
Practice Address - Phone:804-478-5006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-21
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040070841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical