=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366025504
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MELISSA ASHTON ISW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/05/2021
-----------------------------------------------------
Last Update Date | 10/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2898 MAHAN DR STE 3
-----------------------------------------------------
City | TALLAHASSEE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32308-5462
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-547-5369
-----------------------------------------------------
Fax | 954-547-5369
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2577 ULYSSES RD
-----------------------------------------------------
City | TALLAHASSEE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32312-4850
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-547-5369
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | ISW21497
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------