Provider Demographics
NPI:1811581135
Name:MUZNY, MELISA WASHINGTON (MS, MED, LPC-A)
Entity Type:Individual
Prefix:
First Name:MELISA
Middle Name:WASHINGTON
Last Name:MUZNY
Suffix:
Gender:F
Credentials:MS, MED, LPC-A
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:WASHINGTON
Other - Last Name:MUZNY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, MED, LPC-A
Mailing Address - Street 1:225 PENNBRIGHT DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-5915
Mailing Address - Country:US
Mailing Address - Phone:832-943-4035
Mailing Address - Fax:
Practice Address - Street 1:225 PENNBRIGHT DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-5915
Practice Address - Country:US
Practice Address - Phone:832-943-4035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-26
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
TX90325101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX373188702Medicaid