Provider Demographics
NPI:1508941824
Name:PINKETT-DAVIS, MELANIE H (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:H
Last Name:PINKETT-DAVIS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:MRS
Other - First Name:MELANIE
Other - Middle Name:H
Other - Last Name:PINKETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:1741 ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205-1531
Mailing Address - Country:US
Mailing Address - Phone:443-923-1886
Mailing Address - Fax:443-923-1875
Practice Address - Street 1:7000 TUDSBURY RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-2675
Practice Address - Country:US
Practice Address - Phone:410-298-7000
Practice Address - Fax:410-448-7366
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD130471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD409825100Medicaid