Healthcare Provider Details

I. General information

NPI: 1467784967
Provider Name (Legal Business Name): MELISSA M CASIL MSCP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2010
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1244 N MARINE CORPS DR
TAMUNING GU
96913-4308
US

IV. Provider business mailing address

PO BOX 8073
TAMUNING GU
96931-8073
US

V. Phone/Fax

Practice location:
  • Phone: 671-647-8262
  • Fax: 671-647-5252
Mailing address:
  • Phone: 671-929-6048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF000093
License Number StateGU

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: