Provider Demographics
NPI:1710622626
Name:SCHUECKLER, MELISSA (CSAC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SCHUECKLER
Suffix:
Gender:F
Credentials:CSAC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2546
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23450-2546
Mailing Address - Country:US
Mailing Address - Phone:757-340-3489
Mailing Address - Fax:757-340-4278
Practice Address - Street 1:228 N LYNNHAVEN RD STE 118
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7514
Practice Address - Country:US
Practice Address - Phone:757-456-0093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)