Healthcare Provider Details

I. General information

NPI: 1356253785
Provider Name (Legal Business Name): MELISSA RENO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4902 OLD OAK DR
ORANGE TX
77632-1319
US

IV. Provider business mailing address

4902 OLD OAK DR
ORANGE TX
77632-1319
US

V. Phone/Fax

Practice location:
  • Phone: 409-779-7232
  • Fax:
Mailing address:
  • Phone: 409-779-7232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number12304
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number97504
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: