Provider Demographics
NPI:1396170825
Name:LARKIN, MELYNDA JOY (LPC)
Entity type:Individual
Prefix:
First Name:MELYNDA
Middle Name:JOY
Last Name:LARKIN
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 1:207 PEACH WAY STE 110
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-4905
Mailing Address - Country:US
Mailing Address - Phone:573-777-8775
Mailing Address - Fax:573-777-8772
Practice Address - Street 1:207 PEACH WAY STE 110
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-4905
Practice Address - Country:US
Practice Address - Phone:573-777-8775
Practice Address - Fax:573-777-8772
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011014364101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health