Provider Demographics
NPI:1942594700
Name:REDDICK, MELANIE K (LPC & LMFT)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:K
Last Name:REDDICK
Suffix:
Gender:F
Credentials:LPC & LMFT
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:K
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC &LMFT
Mailing Address - Street 1:2200 MARKET ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-1530
Mailing Address - Country:US
Mailing Address - Phone:409-938-4814
Mailing Address - Fax:409-938-4848
Practice Address - Street 1:1501 N AMBURN RD
Practice Address - Street 2:SUTE 13
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-2484
Practice Address - Country:US
Practice Address - Phone:409-938-4814
Practice Address - Fax:409-938-4849
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12066101YM0800X
TX4605106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist