Provider Demographics
NPI:1215041587
Name:THE MELWOOD CENTER FOR COUNSELING & PSYCHOTHERAPY,INC.
Entity Type:Organization
Organization Name:THE MELWOOD CENTER FOR COUNSELING & PSYCHOTHERAPY,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:GUEDALIA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-907-8995
Mailing Address - Street 1:4400 E WEST HWY
Mailing Address - Street 2:SUITE 712
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4524
Mailing Address - Country:US
Mailing Address - Phone:301-907-8995
Mailing Address - Fax:301-907-9389
Practice Address - Street 1:4400 E WEST HWY
Practice Address - Street 2:SUITE 712
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4524
Practice Address - Country:US
Practice Address - Phone:301-907-8995
Practice Address - Fax:301-907-9389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01512103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty