Provider Demographics
NPI:1568520575
Name:NYLANDER, MELISSA KAY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:KAY
Last Name:NYLANDER
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 1:2501 ALEXANDER CT
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-7917
Mailing Address - Country:US
Mailing Address - Phone:512-560-5358
Mailing Address - Fax:
Practice Address - Street 1:2501 ALEXANDER CT
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-7917
Practice Address - Country:US
Practice Address - Phone:512-560-5358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPENDINGMedicaid
TXPENDINGMedicaid