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General NPI Number Information
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NPI Number | 1699232173
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Entity Type | Individual
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Provider Name | ALEXIS MELVILLE PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 02/21/2019
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 4094 MAJESTIC LN UNIT 315
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City | FAIRFAX
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State | VA
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Zip | 22033-2104
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Country | US
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Telephone | 860-796-4553
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Fax |
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Provider Business Mailing Address
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Address Line | 263 FARMINGTON AVE
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City | FARMINGTON
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State | CT
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Zip | 06030-8082
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Country | US
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Telephone | 860-679-6700
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Fax | 860-679-6736
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 810005503
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 004690
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License Number State | CT
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