Provider Demographics
NPI:1750191177
Name:DAYAN, MELANIE ROSELYNE (MA, LPC-R, SOTP)
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:ROSELYNE
Last Name:DAYAN
Suffix:
Gender:F
Credentials:MA, LPC-R, SOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 BROOK RD STE B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-1801
Mailing Address - Country:US
Mailing Address - Phone:804-644-4444
Mailing Address - Fax:
Practice Address - Street 1:11548 OLDE TIVERTON CIR APT 202
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20194-1972
Practice Address - Country:US
Practice Address - Phone:571-479-0661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704017465101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional