Healthcare Provider Details

I. General information

NPI: 1083979751
Provider Name (Legal Business Name): MELISSA ELIZABETH MULLER M.ED., NCC, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2012
Last Update Date: 05/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 S EUCLID AVE STE 5
PASADENA CA
91101-2472
US

IV. Provider business mailing address

130 S EUCLID AVE STE 5
PASADENA CA
91101-2472
US

V. Phone/Fax

Practice location:
  • Phone: 323-580-8080
  • Fax:
Mailing address:
  • Phone: 323-580-8080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC4012
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC4012
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: