Healthcare Provider Details

I. General information

NPI: 1114546595
Provider Name (Legal Business Name): MELANIE FARAH SHERZAD LICSW, SUDPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 POST ALY
SEATTLE WA
98101-1074
US

IV. Provider business mailing address

1200 12TH AVE S STE 901
SEATTLE WA
98144-2712
US

V. Phone/Fax

Practice location:
  • Phone: 206-728-4143
  • Fax:
Mailing address:
  • Phone: 206-548-3114
  • Fax: 206-962-2342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW61440983
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCO61086915
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: