Provider Demographics
NPI:1700962297
Name:HORNE, MELODI DJAHANBANI (LCSW)
Entity Type:Individual
Prefix:
First Name:MELODI
Middle Name:DJAHANBANI
Last Name:HORNE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7645 LEESBURG PIKE STE B
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-2599
Mailing Address - Country:US
Mailing Address - Phone:703-300-5797
Mailing Address - Fax:
Practice Address - Street 1:7645 LEESBURG PIKE STE B
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-2599
Practice Address - Country:US
Practice Address - Phone:703-300-5797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040060471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical