Provider Demographics
NPI:1306175617
Name:EISNER, MELANIE LYNNE (LCSW-C, LICSW)
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:LYNNE
Last Name:EISNER
Suffix:
Gender:F
Credentials:LCSW-C, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8102 GREENWOOD AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6841
Mailing Address - Country:US
Mailing Address - Phone:240-994-0405
Mailing Address - Fax:240-994-0405
Practice Address - Street 1:8102 GREENWOOD AVE APT 2
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6841
Practice Address - Country:US
Practice Address - Phone:240-994-0405
Practice Address - Fax:240-994-0405
Is Sole Proprietor?:No
Enumeration Date:2009-12-15
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD18291OtherSOCIAL WORK LICENSE
DCLC50079858OtherSOCIAL WORK LICENSE