Provider Demographics
NPI:1932822996
Name:EGLAND, MELISSA DAWN (LCSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:DAWN
Last Name:EGLAND
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 1:1220 AUGUSTA DR STE 290
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-2263
Mailing Address - Country:US
Mailing Address - Phone:713-428-8700
Mailing Address - Fax:
Practice Address - Street 1:1220 AUGUSTA DR STE 290
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-2263
Practice Address - Country:US
Practice Address - Phone:713-428-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX684231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical