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General NPI Number Information
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NPI Number | 1558974824
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Entity Type | Individual
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Provider Name | MELODY DOMINIQUE VARNER PHD, LPCC
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Gender | Female
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Dates
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Enumeration Date | 08/26/2020
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 24660 GOLDSTON CT
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City | MORENO VALLEY
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State | CA
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Zip | 92551-4092
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Country | US
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Telephone | 951-533-1557
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Fax |
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Provider Business Mailing Address
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Address Line | 24660 GOLDSTON CT
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City | MORENO VALLEY
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State | CA
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Zip | 92551-4092
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Country | US
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Telephone | 951-533-1557
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC008696
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPCC7793
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License Number State | CA
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