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NPI Code Detail

MEDICARE: MELISSA DASSANAYAKE LCSW

MEDICARE: MELISSA DASSANAYAKE LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2104100000XSocial Worker
31041C0700XClinical Social Worker

General Provider Information

NPI Number : 1679973051
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA DASSANAYAKE LCSW
Provider Business Mailing Address
First Line : PO BOX 35380
Second Line :
City : LAS VEGAS
State : NV
Zip : 89133-5380
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1661 GOLDEN RAIN RD
Second Line :
City : SEAL BEACH
State : CA
Zip : 90740-4907
Country : US
Telephone Number : 562-493-9581
Fax Number : 562-795-6389
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2014
Last Update Date : 01/19/2026

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