Provider Demographics
NPI:1427563774
Name:DOMBROWSKI, MELISSA DEANNA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:DEANNA
Last Name:DOMBROWSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:DEANNA
Other - Last Name:DOMBROWSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1100 MEREDITH LN APT 716
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4669
Mailing Address - Country:US
Mailing Address - Phone:773-910-1730
Mailing Address - Fax:
Practice Address - Street 1:1100 MEREDITH LN APT 716
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4669
Practice Address - Country:US
Practice Address - Phone:773-910-1730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-08
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1042061041C0700X
IL149.0196201041C0700X
IN34008181A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical