Lisa Melendy, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

41110 Issued in ID

Practice address

82 S Baltic PL
Meridian, ID 83642-5935

Phone

(732) 272-8187

NPI assigned

Sep 9, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Moonlight Mountain Recovery, Inc

  • Substance Abuse Rehabilitation Facility
  • Pocatello, ID
  • NPI 1861983413
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1003585464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 W BRIDGER AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836511944",
            "telephone_number": "732-272-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 S BALTIC PL",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425935",
            "telephone_number": "732-272-8187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELENDY",
        "first_name": "LISA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2024-08-01",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "41110",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-41110",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Nichole Mehling, PHARMD
• Marina Mehta
• Svetlana Meier, MD
• John Tanner Meirndorf, APRN-CNP,
• Alfredo Mejia, LMSW
• Melinda Kaserman, LLC
• Mary Jane Mello, MS,OTR/L
• Michaela Beth Mello
• David Meltzer, D.C.
• Gordon Riley Melvin, RPH

• Clinical Social Worker in Meridian, ID
• Providers in Meridian, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.