Healthcare Provider Details

I. General information

NPI: 1346533114
Provider Name (Legal Business Name): MELINDA KAYE VANDERSCHAAF LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELINDA KAYE FORGA LPC

II. Dates (important events)

Enumeration Date: 05/26/2011
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 W PAWNEE COURT WAY
MUSTANG OK
73064-3950
US

IV. Provider business mailing address

531 W PAWNEE COURT WAY
MUSTANG OK
73064-3950
US

V. Phone/Fax

Practice location:
  • Phone: 405-510-4894
  • Fax:
Mailing address:
  • Phone: 405-510-4894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number22750
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number4983
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: