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Organization
MELISSA ILLARIO, LICENSED CLINICAL SOCIAL WORKER PC
Active
Organization
MELISSA ILLARIO, LICENSED CLINICAL SOCIAL WORKER PC
Active
Other names
Future Self Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA TACY ILLARIO LCSW (MANAGING MEMBER)
(801) 615-3160
Entity
Organization
Contact information
Practice address
1044 N ANAHEIM BLVD UNIT 2, ANAHEIM, CA 92801-7567
(801) 615-3160
Mailing address
1044 N ANAHEIM BLVD UNIT 2, ANAHEIM, CA 92801-7567
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/24/2024
Last updated
12/17/2024
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