Provider Demographics
NPI:1851700835
Name:MELENDEZ MIRANDA, ORLANDO YAMIR (LCSW)
Entity Type:Individual
Prefix:
First Name:ORLANDO
Middle Name:YAMIR
Last Name:MELENDEZ MIRANDA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:ORLANDO
Other - Middle Name:YAMIR
Other - Last Name:MELENDEZ MIRANDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:9194 WYCHE KNOLL LN
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-1765
Mailing Address - Country:US
Mailing Address - Phone:703-659-4524
Mailing Address - Fax:
Practice Address - Street 1:9194 WYCHE KNOLL LN
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-1765
Practice Address - Country:US
Practice Address - Phone:787-293-7999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR113881041C0700X
VA09040158841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical