Provider Demographics
NPI:1003379140
Name:LEGRAND, MELONIE (LCSW-C)
Entity type:Individual
Prefix:DR
First Name:MELONIE
Middle Name:
Last Name:LEGRAND
Suffix:
Gender:
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 1:1939 DRUID HILL AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-3503
Mailing Address - Country:US
Mailing Address - Phone:443-675-7295
Mailing Address - Fax:
Practice Address - Street 1:1939 DRUID HILL AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-3503
Practice Address - Country:US
Practice Address - Phone:443-675-7295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-06
Last Update Date:2025-03-04
Deactivation Date:2020-04-27
Deactivation Code:
Reactivation Date:2022-01-13
Provider Licenses
StateLicense IDTaxonomies
MD22807104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker