Healthcare Provider Details

I. General information

NPI: 1932011574
Provider Name (Legal Business Name): MELANIE LEIGH DUNNUCK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 W JUDGE PEREZ DR
CHALMETTE LA
70043-4904
US

IV. Provider business mailing address

3826 JENA ST APT B
NEW ORLEANS LA
70125-4430
US

V. Phone/Fax

Practice location:
  • Phone: 504-656-4325
  • Fax:
Mailing address:
  • Phone: 248-719-9057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLC11541
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: