Provider Demographics
NPI:1003928458
Name:HEWITT, MELENA K (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:MELENA
Middle Name:K
Last Name:HEWITT
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6820 BETTY LEVY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78227-1160
Mailing Address - Country:US
Mailing Address - Phone:210-292-0405
Mailing Address - Fax:210-671-2207
Practice Address - Street 1:2239 MCCHORD ST BLDG 1245
Practice Address - Street 2:
Practice Address - City:LACKLAND A F B
Practice Address - State:TX
Practice Address - Zip Code:78236-5133
Practice Address - Country:US
Practice Address - Phone:210-292-5967
Practice Address - Fax:210-671-2207
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical