Individual provider Active NPI

Melissa Reyerson-Slifer, LMSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1740775568
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
121273 Issued in CA
Practice address
702 Broadway Unit 1403
San Diego, CA 92101-5341
Phone
(515) 443-4730
NPI assigned
Jun 25, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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 121273 CA Primary
Clinical Social Worker 1041C0700X 090798 IA

Addresses

Primary practice location

702 Broadway Unit 1403
San Diego, CA 92101-5341

Mailing address

702 Broadway Unit 1403
San Diego, CA 92101-5341
Phone (515) 443-4730

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
121273CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1740775568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 BROADWAY UNIT 1403",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921015341",
            "telephone_number": "515-443-4730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 BROADWAY UNIT 1403",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921015341",
            "telephone_number": "515-443-4730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYERSON-SLIFER",
        "first_name": "MELISSA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "121273",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "090798",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.