Individual provider · NPI-1

Melanie Bariso Agustin, LPC

Counselor, Professional · Norfolk, VA

NPI number1194581322
StatusActive
Last updated in NPPESFeb 26, 2024

Details

NPI
1194581322
Entity type
Individual (NPI-1)
Name
Melanie Bariso Agustin
Credential
LPC
Sex
Female
Sole proprietor
No
Enumeration date
Feb 26, 2024
Certification date
Feb 26, 2024
Last updated
Feb 26, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, Professional0701013286VAYes

Practice location

401 Gresham Dr
Norfolk, VA 23507

Phone 757-668-4673

Mailing address

850 Southampton Ave
Norfolk, VA 23510-1021

Phone 757-668-5470 · Fax 757-668-8870

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