Provider Demographics
NPI:1982061933
Name:FELIPE, MELLYSA (MSW)
Entity type:Individual
Prefix:
First Name:MELLYSA
Middle Name:
Last Name:FELIPE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10720 CARIBBEAN BLVD STE 320
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-1244
Mailing Address - Country:US
Mailing Address - Phone:786-234-5888
Mailing Address - Fax:786-231-5880
Practice Address - Street 1:10720 CARIBBEAN BLVD STE 320
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-1244
Practice Address - Country:US
Practice Address - Phone:786-234-5888
Practice Address - Fax:786-231-5880
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016613000Medicaid