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NPI Code Detail

MEDICARE: MELISSA JANDT LCSW

MEDICARE:   MELISSA  JANDT  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 Worker

General Provider Information

NPI Number : 1164796876
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA JANDT LCSW
Provider Business Mailing Address
First Line : 8222 S 48TH ST STE 200
Second Line :
City : PHOENIX
State : AZ
Zip : 85044-5303
Country : US
Telephone Number : 520-640-7189
Fax Number : 800-725-1576
Provider Business Practice Location Address
First Line : 8222 S 48TH ST STE 200
Second Line :
City : PHOENIX
State : AZ
Zip : 85044-5303
Country : US
Telephone Number : 623-300-5477
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2012
Last Update Date : 11/07/2025

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Directions to “ MELISSA JANDT LCSW” Practice Location

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