Provider Demographics
NPI:1578841995
Name:BROWN, MELISSA LOUISE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LOUISE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:LOUISE
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:700 LEEWARD CT
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-5261
Mailing Address - Country:US
Mailing Address - Phone:301-806-6606
Mailing Address - Fax:
Practice Address - Street 1:700 LEEWARD CT
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5261
Practice Address - Country:US
Practice Address - Phone:301-806-6606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD109811041C0700X
DCLC3033571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical