Provider Demographics
NPI:1871650515
Name:MORRISSETTE, MELISSA ANN (MSW, LICSW CMHS)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:MORRISSETTE
Suffix:
Gender:F
Credentials:MSW, LICSW CMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 515
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-0515
Mailing Address - Country:US
Mailing Address - Phone:206-755-7908
Mailing Address - Fax:206-000-0000
Practice Address - Street 1:406 MAIN ST STE 115
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-3166
Practice Address - Country:US
Practice Address - Phone:206-755-7908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW60090854101Y00000X, 1041C0700X, 104100000X
WACP00006445101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical