Melissa Illario, Licensed Clinical Social Worker PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MELISSA ILLARIO, LICENSED CLINICAL SOCIAL WORKER PC

Doing business as

Future Self Counseling

Practice address

1044 N Anaheim Blvd Unit 2
Anaheim, CA 92801-7567

Phone

(801) 615-3160

NPI assigned

Jun 24, 2024

Last updated

Dec 17, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melissa Tacy Illario, LCSWNPI 1629632575

Title

Managing Member

Phone

(801) 615-3160

Specialties & licenses 1

Addresses

Other names 1

• Future Self Counseling Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Melissa Tacy Illario

  • Clinical Social Worker
  • Anaheim, CA
  • NPI 1629632575
  NPD Authorized official

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

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734393600000",
    "number": "1598509499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 N ANAHEIM BLVD UNIT 2",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928017567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 N ANAHEIM BLVD UNIT 2",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928017567",
            "telephone_number": "801-615-3160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 Santa Maria",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926060621",
            "country_code": "US",
            "telephone_number": "801-615-3160",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10362 S Ashley Meadows Cir",
            "address_purpose": "LOCATION",
            "city": "Sandy",
            "state": "UT",
            "postal_code": "840927200",
            "country_code": "US",
            "telephone_number": "801-615-3160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MELISSA ILLARIO, LICENSED CLINICAL SOCIAL WORKER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A",
        "authorized_official_last_name": "ILLARIO",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "TACY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "801-615-3160",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Future Self Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Future Self Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Robert Joseph Melton, CST

• Clinical Social Worker in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.