Provider Demographics
NPI:1932750270
Name:WOODEN, MELISSA (LPC, CAADC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:WOODEN
Suffix:
Gender:F
Credentials:LPC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 333
Mailing Address - Street 2:
Mailing Address - City:CLOVER
Mailing Address - State:VA
Mailing Address - Zip Code:24534-0333
Mailing Address - Country:US
Mailing Address - Phone:434-470-0762
Mailing Address - Fax:
Practice Address - Street 1:1073 MOSELY FERRY ROAD
Practice Address - Street 2:
Practice Address - City:CLOVER
Practice Address - State:VA
Practice Address - Zip Code:24534
Practice Address - Country:US
Practice Address - Phone:434-470-0762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-27
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty