Provider Demographics
NPI:1801539747
Name:MORA, MELINA A (MS, NCC, LPC)
Entity type:Individual
Prefix:MS
First Name:MELINA
Middle Name:A
Last Name:MORA
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6913 WESTLAWN DR
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-2651
Mailing Address - Country:US
Mailing Address - Phone:571-438-3663
Mailing Address - Fax:
Practice Address - Street 1:6913 WESTLAWN DR
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-2651
Practice Address - Country:US
Practice Address - Phone:571-438-3663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013754101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health