Provider Demographics
NPI:1942494331
Name:BONDURANT, MELINDA DENISE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:DENISE
Last Name:BONDURANT
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:PO BOX 845
Mailing Address - Street 2:
Mailing Address - City:FLOMATON
Mailing Address - State:AL
Mailing Address - Zip Code:36441-0845
Mailing Address - Country:US
Mailing Address - Phone:251-296-2249
Mailing Address - Fax:251-296-2286
Practice Address - Street 1:722 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:BREWTON
Practice Address - State:AL
Practice Address - Zip Code:36426-1708
Practice Address - Country:US
Practice Address - Phone:334-222-1818
Practice Address - Fax:334-222-1919
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLPC02659106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist