Healthcare Provider Details

I. General information

NPI: 1942494331
Provider Name (Legal Business Name): MELINDA DENISE BONDURANT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 BELLEVILLE AVE
BREWTON AL
36426-1500
US

IV. Provider business mailing address

3814 OLD ATMORE RD
FLOMATON AL
36441-5260
US

V. Phone/Fax

Practice location:
  • Phone: 251-236-4828
  • Fax: 251-725-9529
Mailing address:
  • Phone: 251-236-4828
  • Fax: 251-725-9529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC02659
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: