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NPI Code Detail

MEDICARE: MELISSA UNICE BANDY MA, LMFT-A, LPC-A

MEDICARE: MELISSA UNICE BANDY MA, LMFT-A, LPC-A
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 Counselor92023TX
2106H00000XMarriage & Family Therapist205131TX

General Provider Information

NPI Number : 1942073598
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA UNICE BANDY MA, LMFT-A, LPC-A
Provider Business Mailing Address
First Line : 702 DE GRUMMOND WAY
Second Line :
City : SALADO
State : TX
Zip : 76571-6030
Country : US
Telephone Number : 909-525-8342
Fax Number :
Provider Business Practice Location Address
First Line : 11615 ANGUS RD STE 218
Second Line :
City : AUSTIN
State : TX
Zip : 78759-4066
Country : US
Telephone Number : 512-492-6200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2023
Last Update Date : 11/06/2023

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