Provider Demographics
NPI:1710182530
Name:AUSTEN, MELISSA ANN (MSSA, LCSW)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:ANN
Last Name:AUSTEN
Suffix:
Gender:F
Credentials:MSSA, LCSW
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:HEASLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSSA, LCSW
Mailing Address - Street 1:530 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:HASKELL
Mailing Address - State:TX
Mailing Address - Zip Code:79521-6504
Mailing Address - Country:US
Mailing Address - Phone:940-276-1030
Mailing Address - Fax:
Practice Address - Street 1:530 S 2ND ST
Practice Address - Street 2:
Practice Address - City:HASKELL
Practice Address - State:TX
Practice Address - Zip Code:79521-6504
Practice Address - Country:US
Practice Address - Phone:940-276-1030
Practice Address - Fax:940-276-1031
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0154601041C0700X
TX597281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical