Healthcare Provider Details

I. General information

NPI: 1962969857
Provider Name (Legal Business Name): MELISSA KARLA DEHOSSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2019
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9357 SW 77TH AVE APT 805
MIAMI FL
33156-3188
US

IV. Provider business mailing address

9357 SW 77TH AVE APT 805
MIAMI FL
33156-3188
US

V. Phone/Fax

Practice location:
  • Phone: 786-366-3610
  • Fax:
Mailing address:
  • Phone: 305-792-8392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW20956
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: