NPI Code Details Logo

NPI 1346171063

NPI 1346171063 : MELISSA BENNITT : LIGNUM, VA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1346171063
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    MELISSA BENNITT
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    05/29/2026
-----------------------------------------------------
    Last Update Date     |    05/29/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    23164 DRAGOON RD 
-----------------------------------------------------
    City                 |    LIGNUM
-----------------------------------------------------
    State                |    VA
-----------------------------------------------------
    Zip                  |    22726-2036
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    540-423-1736
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    9 RAVENSWORTH CT 
-----------------------------------------------------
    City                 |    FREDERICKSBURG
-----------------------------------------------------
    State                |    VA
-----------------------------------------------------
    Zip                  |    22405-2155
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    101YP2500X
-----------------------------------------------------
    Taxonomy Name        |    Professional Counselor
-----------------------------------------------------
    License Number       |    0701016203
-----------------------------------------------------
    License Number State |    VA
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.