Provider Demographics
NPI:1629744297
Name:STCLAIR, MELANIE DAWN (LPC, ALPS)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:DAWN
Last Name:STCLAIR
Suffix:
Gender:F
Credentials:LPC, ALPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:354 BRUSHY FORK RD
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-6677
Mailing Address - Country:US
Mailing Address - Phone:304-704-0029
Mailing Address - Fax:
Practice Address - Street 1:354 BRUSHY FORK RD
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-6677
Practice Address - Country:US
Practice Address - Phone:304-704-0029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1924101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional