Provider Demographics
NPI:1346533114
Name:VANDERSCHAAF, MELINDA KAYE (LPC)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:KAYE
Last Name:VANDERSCHAAF
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:KAYE
Other - Last Name:FORGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:19508 DANFORTH FARMS BLVD.
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012
Mailing Address - Country:US
Mailing Address - Phone:405-510-4894
Mailing Address - Fax:
Practice Address - Street 1:1015 WATERWOOD PKWY #G-L-1
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034
Practice Address - Country:US
Practice Address - Phone:405-510-4894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor