Healthcare Provider Details

I. General information

NPI: 1275465940
Provider Name (Legal Business Name): MELISSA FAYE SHILLING LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4420 S 32ND ST
PHOENIX AZ
85040-2804
US

IV. Provider business mailing address

170 E GUADALUPE RD UNIT 115
GILBERT AZ
85234-4654
US

V. Phone/Fax

Practice location:
  • Phone: 602-268-8748
  • Fax: 602-253-1557
Mailing address:
  • Phone: 602-268-8748
  • Fax: 602-253-1557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-23820
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: