Healthcare Provider Details

I. General information

NPI: 1821613902
Provider Name (Legal Business Name): MELISSA SAMIO LCSW, BCD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2020
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JARRETT WHITE RD
TRIPLER ARMY MEDICAL CENTER HI
96859-5001
US

IV. Provider business mailing address

1463 HAPUU LOOP
WAHIAWA HI
96786-6010
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-8880
  • Fax:
Mailing address:
  • Phone: 302-373-2753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberC013232
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: