Provider Demographics
NPI:1336409499
Name:ASONGWED, MELVIS NDIBABONGA (LCSW-C)
Entity Type:Individual
Prefix:
First Name:MELVIS
Middle Name:NDIBABONGA
Last Name:ASONGWED
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 1:404 DYER DR
Mailing Address - Street 2:
Mailing Address - City:ACCOKEEK
Mailing Address - State:MD
Mailing Address - Zip Code:20607-9576
Mailing Address - Country:US
Mailing Address - Phone:202-322-4707
Mailing Address - Fax:
Practice Address - Street 1:404 DYER DR
Practice Address - Street 2:
Practice Address - City:ACCOKEEK
Practice Address - State:MD
Practice Address - Zip Code:20607-9576
Practice Address - Country:US
Practice Address - Phone:202-322-4707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X, 103TF0200X
MD224261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No374U00000XNursing Service Related ProvidersHome Health Aide
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic