Provider Demographics
NPI:1407979834
Name:HUBER, MELISSA M (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:M
Last Name:HUBER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:M
Other - Last Name:WUECNHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:601 PERRYVILLE DRIVE
Mailing Address - Street 2:
Mailing Address - City:PERRY POINT
Mailing Address - State:MD
Mailing Address - Zip Code:21902
Mailing Address - Country:US
Mailing Address - Phone:410-642-2411
Mailing Address - Fax:
Practice Address - Street 1:601 PERRYVILLE DRIVE
Practice Address - Street 2:
Practice Address - City:PERRY POINT
Practice Address - State:MD
Practice Address - Zip Code:21902
Practice Address - Country:US
Practice Address - Phone:410-642-2411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD106031041C0700X
MD1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical