Provider Demographics
NPI:1902612849
Name:MELODY CHOW THERAPY LLC
Entity type:Organization
Organization Name:MELODY CHOW THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOW
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LICSW
Authorized Official - Phone:650-238-8953
Mailing Address - Street 1:6635 N BALTIMORE AVE STE 279
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203-5462
Mailing Address - Country:US
Mailing Address - Phone:971-279-8690
Mailing Address - Fax:
Practice Address - Street 1:6635 N BALTIMORE AVE STE 279
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203-5462
Practice Address - Country:US
Practice Address - Phone:971-279-8690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-05
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty