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NPI Code Detail

MEDICARE: MELISSA MCKISSICK LPC

MEDICARE:   MELISSA  MCKISSICK  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
1101YM0800XMental Health Counselor0701007568VA

General Provider Information

NPI Number : 1346743499
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA MCKISSICK LPC
Provider Business Mailing Address
First Line : 11221 ABINGDON CT
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23236-4311
Country : US
Telephone Number : 804-839-0369
Fax Number :
Provider Business Practice Location Address
First Line : 6200 LAKESIDE AVE
Second Line :
City : HENRICO
State : VA
Zip : 23228-5248
Country : US
Telephone Number : 804-307-2801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2018
Last Update Date : 09/18/2025

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