Provider Demographics
NPI:1720378961
Name:LOZITO, MELISSA (DSW, MSW, LSWAIC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:LOZITO
Suffix:
Gender:F
Credentials:DSW, MSW, LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21540 30TH DR SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-7015
Mailing Address - Country:US
Mailing Address - Phone:425-424-1100
Mailing Address - Fax:
Practice Address - Street 1:21540 30TH DR SE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021
Practice Address - Country:US
Practice Address - Phone:425-424-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC605055171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical