Provider Demographics
NPI:1558963579
Name:MCGARVEY, MELINDA MAYNE (LICSW, LCSW)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:MAYNE
Last Name:MCGARVEY
Suffix:
Gender:F
Credentials:LICSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 ROUNDHOUSE LN APT 301
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-5930
Mailing Address - Country:US
Mailing Address - Phone:858-229-4899
Mailing Address - Fax:
Practice Address - Street 1:109 ORONOCO ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-2015
Practice Address - Country:US
Practice Address - Phone:703-261-4191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-13
Last Update Date:2023-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108043101YM0800X
VA09040125601041C0700X
DCLC500826201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health