Provider Demographics
NPI:1912440538
Name:STRAKER, MELISSA (MS, LPC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:STRAKER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3366 DURHAM RD
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-1817
Mailing Address - Country:US
Mailing Address - Phone:609-482-3701
Mailing Address - Fax:609-648-2370
Practice Address - Street 1:3366 DURHAM RD
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902
Practice Address - Country:US
Practice Address - Phone:609-482-3701
Practice Address - Fax:609-648-2370
Is Sole Proprietor?:No
Enumeration Date:2016-11-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008734101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA097115OtherDDAP- ID # 097115, PA
PA144400OtherDOH-MH- ID # 144400, PA
NJ2000480OtherDMHAS- SUD, ID # 2000480, NJ
NJ8963OtherDMHAS- MH, ID # 8963 NJ