Provider Demographics
NPI:1871855247
Name:HIRALDO-MELENDEZ, TANIA M (LCPC, NCC, BC-TMH)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:M
Last Name:HIRALDO-MELENDEZ
Suffix:
Gender:F
Credentials:LCPC, NCC, BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 UNIVERSITY BLVD E STE 245
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-4646
Mailing Address - Country:US
Mailing Address - Phone:240-752-2707
Mailing Address - Fax:
Practice Address - Street 1:1425 UNIVERSITY BLVD E STE 245
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-4646
Practice Address - Country:US
Practice Address - Phone:240-752-2767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5489101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLGP4344OtherLICENSED GRADUATE PROFESSIONAL COUNSELOR