Melissa Brak, LSW
Individual provider Active NPI Social Worker · Lisbon, OH
NPI 1396127601 · NPPES record last updated Jun 23, 2015
Key facts
- NPI
- 1396127601
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- S.0901398 (OH)
- Practice address
- 40722 State Route 154
Lisbon, OH 44432-8500 - Phone
- (330) 424-9573
- Fax
- (330) 424-0877
- NPI assigned
- Jun 23, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.0901398 | OH | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.0901398 | OH | Yes |
Addresses
Primary practice location
40722 State Route 154
Lisbon, OH 44432-8500
Mailing address
46945 Carmel Achor Rd
Rogers, OH 44455-9747
Phone (330) 429-2090
Other providers in Lisbon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.