Melissa Fatima Maynes, M.A.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LF60143370 Issued in WA

Practice address

9040 Jackson Ave
Tacoma, WA 98431-0001

Phone

(253) 968-6065

NPI assigned

Jul 7, 2008

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

• Miss Melissa Fatima Puccio Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1962665331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6623 133RD ST E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983736316",
            "telephone_number": "253-538-7303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-6065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNES",
        "first_name": "MELISSA",
        "middle_name": "FATIMA",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60013965",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60088360",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF60143370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "PUCCIO",
            "middle_name": "FATIMA",
            "prefix": "MISS",
            "credential": "LMFT, LMHC, CDP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Zarah Elizabeth Mayewski, PHARMD, RPH
• Roger Lee Mayfield, DDS
• Rachel Mayhew, PT, DPT
• Steven R Maynard, M.D.
• Richard Mayne, MA, MHCA
• Kaelyn M Mayo, LMP
• Rebecca Marie Mayor, OTA
• Robert A Mazzoli, MD
• Anastasia Mburu
• Jane Mburu

• Marriage & Family Therapist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.