Provider Demographics
NPI:1528147162
Name:CROWN, MELISSA F (LCSWC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:F
Last Name:CROWN
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5514 ROOSEVELT ST
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-3782
Mailing Address - Country:US
Mailing Address - Phone:301-897-8747
Mailing Address - Fax:
Practice Address - Street 1:8818 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2713
Practice Address - Country:US
Practice Address - Phone:240-777-1455
Practice Address - Fax:240-777-1367
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05686101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health