Provider Demographics
NPI:1114899275
Name:KIRKPATRICK, MELISSA MARIE (MSW, LGSW, CSOTP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:MSW, LGSW, CSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1443 ROCK SPRING RD UNIT 259
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-1920
Mailing Address - Country:US
Mailing Address - Phone:301-327-6007
Mailing Address - Fax:
Practice Address - Street 1:13000 HARBOR CENTER DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2846
Practice Address - Country:US
Practice Address - Phone:703-492-2994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0906016928104100000X
VA0812000958174400000X
DCLG200004330104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty