Provider Demographics
NPI:1811581135
Name:MUZNY, MELISA WASHINGTON (MS, MED, LPC)
Entity type:Individual
Prefix:
First Name:MELISA
Middle Name:WASHINGTON
Last Name:MUZNY
Suffix:
Gender:
Credentials:MS, MED, LPC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:WASHINGTON
Other - Last Name:MUZNY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, MED, LPC
Mailing Address - Street 1:1700 COVEMEADOW DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-5407
Mailing Address - Country:US
Mailing Address - Phone:281-836-3704
Mailing Address - Fax:
Practice Address - Street 1:1700 COVEMEADOW DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-5407
Practice Address - Country:US
Practice Address - Phone:281-836-3704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-26
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90325101YM0800X, 101YP2500X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX373188702Medicaid