Provider Demographics
NPI:1790174175
Name:MELLOTT-LAMAR, DANIELE NICOLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DANIELE
Middle Name:NICOLE
Last Name:MELLOTT-LAMAR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DANIELE
Other - Middle Name:NICOLE
Other - Last Name:MELLOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:8008 SUNFLOWER CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:PA
Mailing Address - Zip Code:17252
Mailing Address - Country:US
Mailing Address - Phone:717-377-7307
Mailing Address - Fax:
Practice Address - Street 1:19 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2212
Practice Address - Country:US
Practice Address - Phone:717-263-7758
Practice Address - Fax:717-263-1147
Is Sole Proprietor?:No
Enumeration Date:2015-01-22
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health