Provider Demographics
NPI:1306419304
Name:FELTON, PATRICIA MELISSA (LPC)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:MELISSA
Last Name:FELTON
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 1:3928 HARDWOOD LN
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-1943
Mailing Address - Country:US
Mailing Address - Phone:757-751-0117
Mailing Address - Fax:
Practice Address - Street 1:1039 CHAMPIONS WAY STE 100
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3772
Practice Address - Country:US
Practice Address - Phone:757-751-0117
Practice Address - Fax:757-282-2638
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-19
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010646101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA101YP2500XMedicaid