Individual provider Active NPI

Melissa Vermilyea, LCSW

  • Clinical Social Worker
  • Gilbert, AZ
National Provider Identifier
1841018017
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-22556 Issued in AZ
Practice address
1166 E Warner Rd Ste 218
Gilbert, AZ 85296-3066
Phone
(480) 331-2412
NPI assigned
Sep 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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 LCSW-22556 AZ Primary

Addresses

Primary practice location

1166 E Warner Rd Ste 218
Gilbert, AZ 85296-3066

Mailing address

1166 E Warner Rd Ste 218
Gilbert, AZ 85296-3066
Phone (480) 331-2412

Other names 1

  • Melissa Moreno Former name

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

State licenses

LicenseStateTypeSpecialty
LCSW-22556AZMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1727395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1841018017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1166 E WARNER RD STE 218",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963066",
            "telephone_number": "480-331-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1166 E WARNER RD STE 218",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963066",
            "telephone_number": "480-331-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERMILYEA",
        "first_name": "MELISSA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-27",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-22556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "MORENO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.