Provider Demographics
NPI:1932972288
Name:MURDOCK, MELINDA REGINE (LMFT)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:REGINE
Last Name:MURDOCK
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 CUSTER DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-4010
Mailing Address - Country:US
Mailing Address - Phone:502-219-3488
Mailing Address - Fax:
Practice Address - Street 1:3150 CUSTER DR STE 300
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-4010
Practice Address - Country:US
Practice Address - Phone:502-219-3488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY287465106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist