Provider Demographics
NPI:1780572362
Name:GNAIZDA-GILSON, MELANIE SARA
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:SARA
Last Name:GNAIZDA-GILSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:SARA
Other - Last Name:GNAIZDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:10481 NW 9TH PL
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-5633
Mailing Address - Country:US
Mailing Address - Phone:954-547-9092
Mailing Address - Fax:
Practice Address - Street 1:12555 ORANGE DRIVE
Practice Address - Street 2:SUITE 217
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071
Practice Address - Country:US
Practice Address - Phone:954-547-9092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7334101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional