Provider Demographics
NPI:1508461914
Name:TELSEY, MELISSA ASHLEY
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ASHLEY
Last Name:TELSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22136 MAJESTIC WOODS WAY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-4544
Mailing Address - Country:US
Mailing Address - Phone:561-706-8484
Mailing Address - Fax:
Practice Address - Street 1:1761 W HILLSBORO BLVD STE 202
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1561
Practice Address - Country:US
Practice Address - Phone:561-706-8485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2022-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL175441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical