MEDICARE: MELISSA HERNDON LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	C5253	OR
2	101YP2500X	Professional Counselor	C5253	OR

General Provider Information

NPI Number	:	1306225503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA HERNDON LPC

Provider Business Mailing Address
First Line	:	6917 FENWICK CT N
Second Line	:
City	:	KEIZER
State	:	OR
Zip	:	97303
Country	:	US
Telephone Number	:	503-390-5637
Fax Number	:

Provider Business Practice Location Address
First Line	:	6917 FENWICK CT N
Second Line	:
City	:	KEIZER
State	:	OR
Zip	:	97303-4327
Country	:	US
Telephone Number	:	775-443-0406
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2015
Last Update Date	:	04/23/2026

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Directions to “ MELISSA HERNDON LPC” Practice Location

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