Melissa Marie Waterfield-Copeland, LPC, LAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

78407 Issued in TX

Practice address

6800 Park Ten Blvd Ste 200S
San Antonio, TX 78213-4293

Phone

(210) 261-1000

Fax

(210) 261-1821

NPI assigned

May 25, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Melissa Marie Purta Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 1, 2024 through Jun 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Speakeasy Therapy PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Park Ridge, IL
  • NPI 1437884848
  NPD Authorized official

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1922536622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 PARK TEN BLVD STE 200S",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782134293",
            "telephone_number": "210-261-1000",
            "fax_number": "210-261-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 PARK TEN BLVD STE 200S",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782134293",
            "telephone_number": "210-261-1000",
            "fax_number": "210-261-1821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16414 San Pedro Ave Ste 710",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782322247",
            "country_code": "US",
            "telephone_number": "847-476-1341",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16414 San Pedro Ave Ste 710",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782322247",
            "country_code": "US",
            "telephone_number": "847-476-1341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATERFIELD-COPELAND",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "credential": "LPC, LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "0000711",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0013368",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "78407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "PURTA",
            "middle_name": "MARIE",
            "credential": "LPC, LAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ingrid Yasirell Wass, LCSW
• Blake Wassom, PHARMD
• Sarah Waszyn, MD
• Tara Watamaleo, IDMT
• Watchtower Home Healthcare LLC
• Waterman Counseling LLC
• Mary C Waterman, NP
• Stacy Perez Waterman, LPC, LCDC
• Adrienne B Waters, RDN
• Ashley Waters, PHD

• Professional Counselor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.