Provider Demographics
NPI:1639998180
Name:HEYWOOD, MELISSA (LMSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:HEYWOOD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 E DIAMOND AVE STE D
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-5331
Mailing Address - Country:US
Mailing Address - Phone:202-313-1993
Mailing Address - Fax:
Practice Address - Street 1:2400 BANNING PL
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-2712
Practice Address - Country:US
Practice Address - Phone:301-445-8433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD259691041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool