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Melanie Diana Randolph, LMHC-A
Mental Health Counselor in Longview, Washington
NPI 1215465570

Melanie Diana Randolph is a Mental Health Counselor based in Longview, WA and is specialized in Mental Health. Melanie Diana Randolph practices in Longview, WA and has the professional credentials of LMHC-A. The NPI Number for Melanie Diana Randolph is 1215465570 and holds a License No. LH60926455 (Washington).

The current practice location address for Melanie Diana Randolph is 1402 Broadway St Ste 207, Longview, WA and can be reached out via phone at 360-749-0629.

Location: 1402 Broadway St Ste 207, Longview, WA, 98632-3714
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1215465570
Provider Name
Melanie Diana Randolph
Credential
LMHC-A
Provider Entity Type
Individual
Gender
Female
Address
1402 Broadway St Ste 207, Longview, WA, 98632-3714
Phone Number
360-749-0629
Fax Number
Provider Enumeration Date
05/31/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2085695 05 WA
institution
Provider Business Practice Location Address Details
Address
1402 Broadway St Ste 207
City
Longview
State
Washington
Zip
98632-3714
Phone Number
360-749-0629
Fax Number
person
Provider Business Mailing Address Details
Address
1402 Broadway St Ste 207
City
Longview
State
Washington
Zip
98632-3714
Phone Number
360-749-0629
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
LH60926455 (Washington)
Definition
Definition to come...
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