Provider Demographics
NPI:1740333095
Name:WARREN, MELISSA GAYE
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:GAYE
Last Name:WARREN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 P ST NW
Mailing Address - Street 2:SUITE 405
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-5915
Mailing Address - Country:US
Mailing Address - Phone:202-256-7469
Mailing Address - Fax:202-543-3025
Practice Address - Street 1:2000 P ST NW
Practice Address - Street 2:SUITE 405
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5915
Practice Address - Country:US
Practice Address - Phone:202-256-7469
Practice Address - Fax:202-543-3025
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC7891790103TC0700X
MD02620103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical