Provider Demographics
NPI:1952481962
Name:MELENBRINK, DENIESE COUNTS (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DENIESE
Middle Name:COUNTS
Last Name:MELENBRINK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 STANHOPE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227
Mailing Address - Country:US
Mailing Address - Phone:804-264-8888
Mailing Address - Fax:804-264-4926
Practice Address - Street 1:705 DAWN STREET
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23222
Practice Address - Country:US
Practice Address - Phone:804-264-8888
Practice Address - Fax:804-264-4926
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA090400003821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006710OtherANTHEM BCBS
VA010259860Medicaid
VA190000614Medicare ID - Type Unspecified