Melissa Sue Proctor, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904015618 Issued in VA

Practice address

8804 Patterson Ave
Richmond, VA 23229-6361

Phone

(804) 592-6311

NPI assigned

Jun 5, 2006

Last updated

Jun 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Previously, effective Sep 25, 2024 through Sep 25, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Richmond Creative Counseling

  dba Wild Oaks

  • Adult Mental Health Clinic/Center
  • North Chesterfield, VA
  • NPI 1285322628

  Clinical

  NPD (past)
• Richmond Creative Counseling, LLC

  • Professional Counselor
  • Richmond, VA
  • NPI 1689016735
  NPD (past)

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1336188655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 PORTER ST APT 308",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232242272",
            "telephone_number": "619-929-4921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8804 PATTERSON AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232296361",
            "telephone_number": "804-592-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "MELISSA",
        "middle_name": "SUE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KY",
            "license": "4948",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "62650",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904015618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336188655",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "62650",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMONWEALTH OF VIRGINIA",
            "identifier": "0904015618",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pro Transport, LLC
• Proactive Behavioral Services, Inc (PBS)
• Proceed Therapy LLC
• Levi David Procter, M.D.
• Darlene Frances Proctor, RN
• Professional Choice Staffing
• Professional Emergency Care, PC
• Professional Healthcare Resources of Richmond, Inc. (Professional Healthcare)
• Professional Mental Health Educational Consultants, LLC
• Professional Nurses, Inc

• Clinical Social Worker in Richmond, VA
• Providers in Richmond, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.