Healthcare Provider Details

I. General information

NPI: 1194029983
Provider Name (Legal Business Name): MELANEY MARIE BRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELANEY MARIE GRANT LCSW

II. Dates (important events)

Enumeration Date: 01/07/2011
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24422 AVENIDA DE LA CARLOTA
LAGUNA HILLS CA
92653-3636
US

IV. Provider business mailing address

18027 BROOKNOLL DR
HOUSTON TX
77084-5949
US

V. Phone/Fax

Practice location:
  • Phone: 346-206-9310
  • Fax:
Mailing address:
  • Phone: 346-206-9310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number73896
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: