Provider Demographics
NPI:1093852279
Name:MOPSICK, MELANIE ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:ELIZABETH
Last Name:MOPSICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 270
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6513
Mailing Address - Country:US
Mailing Address - Phone:916-568-1058
Mailing Address - Fax:916-487-7165
Practice Address - Street 1:455 UNIVERSITY AVE
Practice Address - Street 2:SUITE 270
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6513
Practice Address - Country:US
Practice Address - Phone:916-568-1058
Practice Address - Fax:916-487-7165
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS18010101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health