Provider Demographics
NPI:1063034981
Name:BROWNDORF, MELANIE S (MS, LPC)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:S
Last Name:BROWNDORF
Suffix:
Gender:
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 POPLAR CT
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-3219
Mailing Address - Country:US
Mailing Address - Phone:215-370-7681
Mailing Address - Fax:
Practice Address - Street 1:4 TERRY DR STE 3E
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1838
Practice Address - Country:US
Practice Address - Phone:215-370-7681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-13
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00663700101YP2500X
PAPC012146101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ37PC00663700OtherSECONDARY STATE LICENSE
PAPC012146OtherPRIMARY LICENSE