Individual provider Active NPI

Melissa Bryant

  • Clinical Social Worker
  • Anaheim, CA
National Provider Identifier
1245713155
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW107616 Issued in CA
Practice address
1702 E Briarvale Ave
Anaheim, CA 92805-1311
Phone
(707) 592-7204
NPI assigned
Sep 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LICSW121888 MA
Clinical Social Worker 1041C0700X LCSW107616 CA Primary

Addresses

Primary practice location

1702 E Briarvale Ave
Anaheim, CA 92805-1311

Mailing address

1702 E Briarvale Ave
Anaheim, CA 92805-1311
Phone (707) 592-7204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190827003541 MA Practitioner - Clinical Social Worker 9234467390 Reassigns benefits to 1 organization
I20220705002018 CA Practitioner - Clinical Social Worker 9234467390 Practice locations: Oceanside, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Oceanside, CA 92057
Phone (707) 592-7204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW107616CAMDClinical Social Worker
LICSW121888MAMDClinical Social Worker
107616CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Jul 31, 2019 Accepting new patients

Locations

872 Massachusetts Ave
Ste 2-2
Cambridge, MA 02139
Phone 6173804651 ext. 1992

929 Massachusetts Ave
Ste 103
Cambridge, MA 02139
Phone (617) 395-5806

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1536278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1245713155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 E BRIARVALE AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928051311",
            "telephone_number": "707-592-7204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 E BRIARVALE AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928051311",
            "telephone_number": "707-592-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-07",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW121888",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW107616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.