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NPI Code Detail

MEDICARE: MELISSA ANN MEZO LCSW

MEDICARE: MELISSA ANN MEZO LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCSW-32985ID

General Provider Information

NPI Number : 1154380715
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA ANN MEZO LCSW
Provider Business Mailing Address
First Line : PO BOX 9
Second Line :
City : NAMPA
State : ID
Zip : 83653-0009
Country : US
Telephone Number : 208-467-4431
Fax Number : 208-466-5359
Provider Business Practice Location Address
First Line : 300 S 23RD ST
Second Line :
City : BOISE
State : ID
Zip : 83702-9100
Country : US
Telephone Number : 208-345-1170
Fax Number : 208-345-3502
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2006
Last Update Date : 11/28/2023

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Directions to “ MELISSA ANN MEZO LCSW” Practice Location

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