Organization
ELEVATED SOUL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELODI HICKEY LCSW, CAM (OWNER/THERAPIST)
(815) 210-0833
Entity
Organization
Contact information
Practice address
1806 SUMMIT AVE STE 300, RICHMOND, VA 23230-4339
(804) 420-9449
(804) 885-2582
Mailing address
1806 SUMMIT AVE STE 300, RICHMOND, VA 23230-4339
(804) 420-9449
(804) 885-2582
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
09/08/2022
Last updated
11/28/2023
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