Provider Demographics
NPI:1558909937
Name:LEVINE, MELANIE ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:ANN
Last Name:LEVINE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:ANN
Other - Last Name:MINEGAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7621 EAGLE RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-3169
Mailing Address - Country:US
Mailing Address - Phone:858-539-6798
Mailing Address - Fax:
Practice Address - Street 1:7621 EAGLE RIDGE CIR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76179-3169
Practice Address - Country:US
Practice Address - Phone:858-539-6798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-16
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical