MEDICARE: METOKA L. WELCH PHD, LCMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	8554	NC

General Provider Information

NPI Number	:	1235834516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	METOKA L. WELCH PHD, LCMHC

Provider Business Mailing Address
First Line	:	9818 KERRY LN
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23238-4923
Country	:	US
Telephone Number	:	540-621-6459
Fax Number	:

Provider Business Practice Location Address
First Line	:	9818 KERRY LN
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23238-4923
Country	:	US
Telephone Number	:	540-621-6459
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2023
Last Update Date	:	04/04/2023

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