Provider Demographics
NPI:1831410398
Name:MARKOWTIZ, MELISSA MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:MARKOWTIZ
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 1:504 RAYMOND DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-2804
Mailing Address - Country:US
Mailing Address - Phone:610-842-0828
Mailing Address - Fax:
Practice Address - Street 1:403 W LINCOLN HWY
Practice Address - Street 2:SUITE 206 A
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2559
Practice Address - Country:US
Practice Address - Phone:610-363-2088
Practice Address - Fax:610-363-2080
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0165711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical