Provider Demographics
NPI:1386878809
Name:SPRINGSTEAD, MARY MELISSA (PSYD, MFT#47113)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:MELISSA
Last Name:SPRINGSTEAD
Suffix:
Gender:F
Credentials:PSYD, MFT#47113
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 S LOS ROBLES AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2872
Mailing Address - Country:US
Mailing Address - Phone:626-437-5583
Mailing Address - Fax:
Practice Address - Street 1:280 S LOS ROBLES AVE UNIT B
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2872
Practice Address - Country:US
Practice Address - Phone:626-437-5583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2016-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47113106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist