Provider Demographics
NPI:1912717042
Name:MELETICHE, VICTORIA LORRAINE (LCSWA)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LORRAINE
Last Name:MELETICHE
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:LORRAINE
Other - Last Name:BROOKHOUSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSWA
Mailing Address - Street 1:3886 HENDERSON DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-5219
Mailing Address - Country:US
Mailing Address - Phone:910-938-9833
Mailing Address - Fax:919-938-9835
Practice Address - Street 1:3886 HENDERSON DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-5219
Practice Address - Country:US
Practice Address - Phone:910-938-9833
Practice Address - Fax:919-938-9835
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-10
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1138551041C0700X
NCP0215701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical