Provider Demographics
NPI:1710677034
Name:KOLKIN, MELANIE ANNE (LICSW)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:ANNE
Last Name:KOLKIN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 L ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-2560
Mailing Address - Country:US
Mailing Address - Phone:404-275-5257
Mailing Address - Fax:
Practice Address - Street 1:440 L ST NW UNIT 212
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-2570
Practice Address - Country:US
Practice Address - Phone:404-275-5257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-10
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC2000018891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical