Provider Demographics
NPI:1346024213
Name:MELENDREZ, KAYLYNN
Entity type:Individual
Prefix:
First Name:KAYLYNN
Middle Name:
Last Name:MELENDREZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2540 EL PASEO RD STE B
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-6019
Mailing Address - Country:US
Mailing Address - Phone:575-243-5846
Mailing Address - Fax:
Practice Address - Street 1:2540 EL PASEO RD STE B
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-6019
Practice Address - Country:US
Practice Address - Phone:575-243-5846
Practice Address - Fax:575-725-5552
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2025-0125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health