Individual provider Active NPI

Tatiana T. Melendez, MA, MSW, LCSW

  • Clinical Social Worker
  • Encino, CA
National Provider Identifier
1205452539
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW89005 Issued in CA
Practice address
16133 Ventura Blvd Ste 1125
Encino, CA 91436-2424
Phone
(818) 522-6212
NPI assigned
Jun 23, 2020
Last updated
Jun 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW89005 CA Primary

Addresses

Primary practice location

16133 Ventura Blvd Ste 1125
Encino, CA 91436-2424

Mailing address

19360 Rinaldi St # 141
Porter Ranch, CA 91326-1607
Phone (818) 522-6212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LCSW89005CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
TTM Licensed Clinical Social Worker Inc. Clinical CurrentSince Jun 28, 2020 Accepting new patients

Locations

16133 Ventura Blvd
Ste 1125
Encino, CA 91436
Phone (310) 804-6962

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1205452539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19360 RINALDI ST # 141",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913261607",
            "telephone_number": "818-522-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16133 VENTURA BLVD STE 1125",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362424",
            "telephone_number": "818-522-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELENDEZ",
        "first_name": "TATIANA",
        "middle_name": "T.",
        "credential": "MA, MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW89005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.