Provider Demographics
NPI:1861859472
Name:BAWA, MELANIE SHAPIRO (LICSW)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:SHAPIRO
Last Name:BAWA
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 1:1614 V ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-2609
Mailing Address - Country:US
Mailing Address - Phone:202-355-5830
Mailing Address - Fax:
Practice Address - Street 1:1614 V ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2609
Practice Address - Country:US
Practice Address - Phone:202-355-5830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500800111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical