Provider Demographics
NPI:1720641319
Name:MELCHIONE, ELIZABETH A (LCPC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:MELCHIONE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:GIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12530 FAIRWOOD PARKWAY
Mailing Address - Street 2:STE 102 PMB# 1273
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720
Mailing Address - Country:US
Mailing Address - Phone:301-281-4247
Mailing Address - Fax:301-245-2024
Practice Address - Street 1:141 LAWNDALE DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3553
Practice Address - Country:US
Practice Address - Phone:301-624-3341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2024-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC11147101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor