Provider Demographics
NPI:1457068389
Name:JUSTICE, MELANIE ROMPELLA (LMFT)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:ROMPELLA
Last Name:JUSTICE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 CALLE RISCOSO
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-1112
Mailing Address - Country:US
Mailing Address - Phone:310-701-6922
Mailing Address - Fax:
Practice Address - Street 1:2315 CALLE RISCOSO
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362-1112
Practice Address - Country:US
Practice Address - Phone:310-701-6922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT77372101YM0800X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health