Provider Demographics
NPI:1841802246
Name:ORTEGA, MELINDA (LCSW)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:ORTEGA
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 1:6617 AVENUE T
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77011-1229
Mailing Address - Country:US
Mailing Address - Phone:832-423-0921
Mailing Address - Fax:713-610-4321
Practice Address - Street 1:6617 AVENUE T
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77011-1229
Practice Address - Country:US
Practice Address - Phone:832-423-0921
Practice Address - Fax:713-610-4321
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX560161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical