Provider Demographics
NPI:1831330430
Name:TRUE, MELISSA A (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:A
Last Name:TRUE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N RUFE SNOW DR STE 202
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-4239
Mailing Address - Country:US
Mailing Address - Phone:682-356-2961
Mailing Address - Fax:682-626-4552
Practice Address - Street 1:4604 VISTA MEADOWS DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244
Practice Address - Country:US
Practice Address - Phone:682-356-2961
Practice Address - Fax:682-626-4552
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-12
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC15051101YM0800X
FLSW13359101YM0800X
TX62198101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW13359OtherLCSW
SCSW.14935CPOtherLICSW
VALCSW-0904013536OtherLCSW
TX62198OtherLCSW
MELC15051OtherLCSW