MELLISA GAIL DOUGLAS M.EDLPC NPI 1720194681

NPI Information

NPI: 1720194681
Provider Name: MELLISA GAIL DOUGLAS, M.ED,LPC
Classification: Counselor - 101Y00000X
Entity Type: Individual
Address:
71 WILSON BLVD STE A1
FISHERSVILLE, VA
ZIP 22939
Phone: (540) 949-4202
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Mellisa Gail Douglas, M.ED,LPC is a counselor in Fishersville, VA. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. Mellisa Gail Douglas, M.ED,LPC NPI is 1720194681. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

71 WILSON BLVD STE A1
FISHERSVILLE, VA
ZIP 22939-283
Phone: (540) 949-4202
Fax: (540) 886-7380

The enumeration date for this NPI number is 8/22/2006 and was last updated on 12/2/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	17005	TEXAS	No
2	101Y00000X	Counselor		0701004135	VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	162090801	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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