Provider Demographics
NPI:1821675497
Name:MEETZE, SELENA (LCSW-C)
Entity Type:Individual
Prefix:
First Name:SELENA
Middle Name:
Last Name:MEETZE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 E WEST HWY APT 1206
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3262
Mailing Address - Country:US
Mailing Address - Phone:301-928-7493
Mailing Address - Fax:
Practice Address - Street 1:11510 OLD GEORGETOWN RD STE F
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2736
Practice Address - Country:US
Practice Address - Phone:301-928-7493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD239671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical