Provider Demographics
NPI:1427710516
Name:KALLMAN, MELISSA CLAIRE (MSW, LCSW)
Entity type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:CLAIRE
Last Name:KALLMAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8649 A C SKINNER PKWY APT 527
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-7879
Mailing Address - Country:US
Mailing Address - Phone:386-562-0886
Mailing Address - Fax:
Practice Address - Street 1:8649 A C SKINNER PKWY APT 527
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7879
Practice Address - Country:US
Practice Address - Phone:386-562-0886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW141911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical