Provider Demographics
NPI:1821585548
Name:MALEK, MELODY JOI (AOD COUNSELOR)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:JOI
Last Name:MALEK
Suffix:
Gender:F
Credentials:AOD COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4129 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1848
Mailing Address - Country:US
Mailing Address - Phone:805-681-5400
Mailing Address - Fax:805-681-5413
Practice Address - Street 1:4129 STATE ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1848
Practice Address - Country:US
Practice Address - Phone:805-964-4795
Practice Address - Fax:805-683-3027
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACI21930318101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)