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NPI Code Detail

MEDICARE: MELISSA E TULLY LPC

MEDICARE: MELISSA E TULLY 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
1101YP2500XProfessional Counselor0701013858VA

General Provider Information

NPI Number : 1467286872
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA E TULLY LPC
Provider Business Mailing Address
First Line : 1955 CASCADES RD
Second Line :
City : BLACKSBURG
State : VA
Zip : 24060-0175
Country : US
Telephone Number : 443-283-3975
Fax Number :
Provider Business Practice Location Address
First Line : 21351 GENTRY DR STE 200
Second Line :
City : STERLING
State : VA
Zip : 20166-8512
Country : US
Telephone Number : 443-283-3975
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2024
Last Update Date : 08/28/2024

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Directions to “ MELISSA E TULLY LPC” Practice Location

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