Provider Demographics
NPI:1942073598
Name:BANDY, MELISSA UNICE (MA, LMFT-A, LPC-A)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:UNICE
Last Name:BANDY
Suffix:
Gender:F
Credentials:MA, LMFT-A, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 DE GRUMMOND WAY
Mailing Address - Street 2:
Mailing Address - City:SALADO
Mailing Address - State:TX
Mailing Address - Zip Code:76571-6030
Mailing Address - Country:US
Mailing Address - Phone:909-525-8342
Mailing Address - Fax:
Practice Address - Street 1:11615 ANGUS RD STE 218
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4066
Practice Address - Country:US
Practice Address - Phone:512-492-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92023101YM0800X
TX205131106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health