Provider Demographics
NPI:1346573375
Name:MELENDEZ RONDA, DIANELYRIS (MA, LPC)
Entity type:Individual
Prefix:
First Name:DIANELYRIS
Middle Name:
Last Name:MELENDEZ RONDA
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:
Other - Last Name:MELENDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:1312 17TH ST # 1344
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-1508
Mailing Address - Country:US
Mailing Address - Phone:720-298-9391
Mailing Address - Fax:844-593-1511
Practice Address - Street 1:12021 PENNSYLVANIA ST STE 202
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-3152
Practice Address - Country:US
Practice Address - Phone:720-298-9391
Practice Address - Fax:844-593-1511
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2024-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0011436101YP2500X
CO11436101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional