Provider Demographics
NPI:1245346766
Name:LEDIG, MELANIE B (LCSW-C)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:B
Last Name:LEDIG
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 1:43847 CHERRY HILL LN
Mailing Address - Street 2:
Mailing Address - City:CALIFORNIA
Mailing Address - State:MD
Mailing Address - Zip Code:20619-4110
Mailing Address - Country:US
Mailing Address - Phone:301-863-9322
Mailing Address - Fax:
Practice Address - Street 1:41900 FENWICK ST
Practice Address - Street 2:SUITE 1
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-3813
Practice Address - Country:US
Practice Address - Phone:301-475-9660
Practice Address - Fax:301-475-8810
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12523104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD517B 64681001OtherCAREFIRST BCBS
MDB950 0008OtherCAREFIRST BCBS FEP & NCA
MD182NN598Medicare ID - Type UnspecifiedMEDICARE
MDB950 0008OtherCAREFIRST BCBS FEP & NCA