Provider Demographics
NPI:1215228853
Name:GEY-BURKE, MELADIE (LPC)
Entity type:Individual
Prefix:
First Name:MELADIE
Middle Name:
Last Name:GEY-BURKE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1199 N FAIRFAX ST STE 802
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-1442
Mailing Address - Country:US
Mailing Address - Phone:703-623-0740
Mailing Address - Fax:
Practice Address - Street 1:1199 N FAIRFAX ST STE 802
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-1442
Practice Address - Country:US
Practice Address - Phone:703-623-0740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-01
Last Update Date:2024-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004905101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional