Provider Demographics
NPI:1730313859
Name:MELEGI, SORAYA FATIMA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SORAYA
Middle Name:FATIMA
Last Name:MELEGI
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 1:1550 MADRUGA AVE STE 509
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3048
Mailing Address - Country:US
Mailing Address - Phone:786-536-9714
Mailing Address - Fax:786-536-9833
Practice Address - Street 1:1550 MADRUGA AVE STE 509
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3048
Practice Address - Country:US
Practice Address - Phone:786-536-9714
Practice Address - Fax:786-536-9833
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW75191041C0700X, 101Y00000X, 101YM0800X, 103K00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No252Y00000XAgenciesEarly Intervention Provider Agency