Provider Demographics
NPI:1396440376
Name:MELVIS BEHAVIORAL HEALTH & FORENSIC CONSULTANCY LLC
Entity type:Organization
Organization Name:MELVIS BEHAVIORAL HEALTH & FORENSIC CONSULTANCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELVIS
Authorized Official - Middle Name:N
Authorized Official - Last Name:ASONGWED
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C, PHDC
Authorized Official - Phone:202-322-4707
Mailing Address - Street 1:404 DYER DR
Mailing Address - Street 2:
Mailing Address - City:ACCOKEEK
Mailing Address - State:MD
Mailing Address - Zip Code:20607-9576
Mailing Address - Country:US
Mailing Address - Phone:202-322-4707
Mailing Address - Fax:
Practice Address - Street 1:404 DYER DR
Practice Address - Street 2:
Practice Address - City:ACCOKEEK
Practice Address - State:MD
Practice Address - Zip Code:20607-9576
Practice Address - Country:US
Practice Address - Phone:240-232-6365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Multi-Specialty