Provider Demographics
NPI:1295799807
Name:STOUDT, MELANIE MORGAN (LPC)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:MORGAN
Last Name:STOUDT
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 1:10305 MEMORY LN
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-8815
Mailing Address - Country:US
Mailing Address - Phone:804-257-9305
Mailing Address - Fax:
Practice Address - Street 1:10305 MEMORY LN
Practice Address - Street 2:SUITE 202
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-8815
Practice Address - Country:US
Practice Address - Phone:804-257-9305
Practice Address - Fax:804-748-9098
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003601101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health