Provider Demographics
NPI:1245005776
Name:MCCORD-JUDKINS, MELONIE (MRC, ALC)
Entity type:Individual
Prefix:MRS
First Name:MELONIE
Middle Name:
Last Name:MCCORD-JUDKINS
Suffix:
Gender:F
Credentials:MRC, ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1536 LAURELWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-4720
Mailing Address - Country:US
Mailing Address - Phone:334-455-0979
Mailing Address - Fax:
Practice Address - Street 1:6766 TAYLOR CIR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3415
Practice Address - Country:US
Practice Address - Phone:334-324-0361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-15
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC04387101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor