Mindful Legacy LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

MINDFUL LEGACY LLC

Practice address

4229 Jefferson Oaks Cir Apt B
Fairfax, VA 22033-4071

Phone

(703) 718-6413

NPI assigned

May 2, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Shekila S Melchior, LPCNPI 1962098145

Title

Licensed Professional Counselor

Phone

(336) 301-9765

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shekila Melchior

  • Professional Counselor
  • Alexandria, VA
  • NPI 1962098145
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702252800000",
    "number": "1013606326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12587 FAIR LAKES CIR # 406",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333822",
            "telephone_number": "336-301-9765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4229 JEFFERSON OAKS CIR APT B",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220334071",
            "telephone_number": "703-718-6413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL LEGACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A",
        "authorized_official_last_name": "MELCHIOR",
        "authorized_official_first_name": "SHEKILA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "336-301-9765",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.