MEDICARE: MELODY AGBISIT PHD

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	101YP2500X	Professional Counselor	701011259	VA

General Provider Information

NPI Number	:	1992477848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELODY AGBISIT PHD

Provider Business Mailing Address
First Line	:	249 W FREEMASON ST APT 304
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23510-1353
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4646 PRINCESS ANNE RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-6464
Country	:	US
Telephone Number	:	757-332-2122
Fax Number	:

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

Provider Enumeration Date	:	09/29/2021
Last Update Date	:	06/22/2026

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