Healthcare Provider Details

I. General information

NPI: 1497210843
Provider Name (Legal Business Name): MELISSA MARY SYKES LPC, CSAC, ATR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA AVANT LPC, CSAC, ATR

II. Dates (important events)

Enumeration Date: 02/08/2019
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 W 21ST ST STE 209
NORFOLK VA
23517-1500
US

IV. Provider business mailing address

435 VIRGINIAN DR
NORFOLK VA
23505-4240
US

V. Phone/Fax

Practice location:
  • Phone: 757-578-5493
  • Fax: 757-585-3521
Mailing address:
  • Phone: 757-630-5624
  • Fax: 757-585-3521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0710103231
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number18-017
License Number StateVA
# 5
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701008469
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: