MEDICARE: MELISSA REYERSON-SLIFER LMSW

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
1	1041C0700X	Clinical Social Worker	121273	CA
2	1041C0700X	Clinical Social Worker	090798	IA

General Provider Information

NPI Number	:	1740775568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA REYERSON-SLIFER LMSW

Provider Business Mailing Address
First Line	:	702 BROADWAY UNIT 1403
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-5341
Country	:	US
Telephone Number	:	515-443-4730
Fax Number	:

Provider Business Practice Location Address
First Line	:	702 BROADWAY UNIT 1403
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-5341
Country	:	US
Telephone Number	:	515-443-4730
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2018
Last Update Date	:	09/08/2025

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