Provider Demographics
NPI:1215091673
Name:MEJIAS, MELISSA COLEEN (LICSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:COLEEN
Last Name:MEJIAS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19125 N CREEK PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-8000
Mailing Address - Country:US
Mailing Address - Phone:253-409-3044
Mailing Address - Fax:
Practice Address - Street 1:19125 N CREEK PKWY STE 120
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-8000
Practice Address - Country:US
Practice Address - Phone:253-409-3044
Practice Address - Fax:360-443-7570
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW 600962051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical