Provider Demographics
NPI:1851663868
Name:MELENDEZ, LOURDES J (LPC)
Entity Type:Individual
Prefix:MS
First Name:LOURDES
Middle Name:J
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644-3134
Mailing Address - Country:US
Mailing Address - Phone:973-930-9014
Mailing Address - Fax:
Practice Address - Street 1:1 BRIDGE PLZ N
Practice Address - Street 2:SUITE 275
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-7101
Practice Address - Country:US
Practice Address - Phone:973-922-0116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00441300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional