Provider Demographics
NPI:1760784896
Name:MELENDEZ, HILARIO T (LMHC)
Entity Type:Individual
Prefix:
First Name:HILARIO
Middle Name:T
Last Name:MELENDEZ
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:MR
Other - First Name:LARRY
Other - Middle Name:T
Other - Last Name:MELENDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:PO BOX 1631
Mailing Address - Street 2:
Mailing Address - City:MESILLA PARK
Mailing Address - State:NM
Mailing Address - Zip Code:88047-1631
Mailing Address - Country:US
Mailing Address - Phone:575-642-9108
Mailing Address - Fax:
Practice Address - Street 1:3831 E LOHMAN AVE
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8447
Practice Address - Country:US
Practice Address - Phone:575-339-3941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0096361101YM0800X
CCHM0194151101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health