Provider Demographics
NPI:1740392869
Name:MAURO, MELINDA LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:LEE
Last Name:MAURO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:LEE
Other - Last Name:HAWKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1212 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-5917
Mailing Address - Country:US
Mailing Address - Phone:559-738-0644
Mailing Address - Fax:559-738-0780
Practice Address - Street 1:1212 W MAIN ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5917
Practice Address - Country:US
Practice Address - Phone:559-738-0644
Practice Address - Fax:559-738-0780
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALL133941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical