Provider Demographics
NPI:1457171050
Name:ZURITA, MELISSA (MS, LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ZURITA
Suffix:
Gender:F
Credentials:MS, LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3913 RUNGE CT W
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-6654
Mailing Address - Country:US
Mailing Address - Phone:972-807-0460
Mailing Address - Fax:
Practice Address - Street 1:3740 S UNIVERSITY DR STE 201
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-3700
Practice Address - Country:US
Practice Address - Phone:972-807-0460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-16
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94554101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional