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General NPI Number Information
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NPI Number | 1598460073
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Entity Type | Individual
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Provider Name | MELISSA LUCAS-ESPINOZA LMSW
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Gender | Female
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Dates
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Enumeration Date | 04/03/2023
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 1345 MONROE AVE NW
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City | GRAND RAPIDS
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State | MI
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Zip | 49505-4671
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Country | US
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Telephone | 616-323-5539
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Fax |
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Provider Business Mailing Address
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Address Line | 1835 BELDEN AVE SW
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City | WYOMING
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State | MI
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Zip | 49509-1320
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Country | US
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Telephone | 616-323-5539
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801116377
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License Number State | MI
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