Provider Demographics
NPI:1477692689
Name:MEADOWS, MELISSA WOODALL (LCSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:WOODALL
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:WOODALL
Other - Last Name:TUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:790 GENERATIONS DR STE 410
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-6720
Mailing Address - Country:US
Mailing Address - Phone:830-625-0599
Mailing Address - Fax:
Practice Address - Street 1:790 GENERATIONS DR STE 410
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-6720
Practice Address - Country:US
Practice Address - Phone:830-625-0599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX319881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX151299801Medicaid
TX86328QOtherBLUE CROSS BLUE SHEILD