Provider Demographics
NPI:1649351008
Name:HAREWOOD, MELANIE WALKER (MSW)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:WALKER
Last Name:HAREWOOD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:LOUISE
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:P.O. BOX 8387
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-0387
Mailing Address - Country:US
Mailing Address - Phone:310-966-6600
Mailing Address - Fax:310-231-0760
Practice Address - Street 1:11303 W WASHINGTON BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-6003
Practice Address - Country:US
Practice Address - Phone:310-482-3225
Practice Address - Fax:310-915-8579
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 178341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical