Provider Demographics
NPI:1891384897
Name:VOLCHOK, MELISSA D (LMFT 261063)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:D
Last Name:VOLCHOK
Suffix:
Gender:F
Credentials:LMFT 261063
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8727 TAMPA AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-3532
Mailing Address - Country:US
Mailing Address - Phone:818-350-3066
Mailing Address - Fax:
Practice Address - Street 1:8727 TAMPA AVE FL 2
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-3532
Practice Address - Country:US
Practice Address - Phone:818-350-3066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261063106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty