Provider Demographics
NPI:1588980833
Name:DAVIS-SHELTON, MADELEINE (LICSW, LMFT)
Entity type:Individual
Prefix:
First Name:MADELEINE
Middle Name:
Last Name:DAVIS-SHELTON
Suffix:
Gender:F
Credentials:LICSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4231 RED MAPLE CT
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-1146
Mailing Address - Country:US
Mailing Address - Phone:240-342-3008
Mailing Address - Fax:202-727-0857
Practice Address - Street 1:35 K ST NE
Practice Address - Street 2:#221
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4216
Practice Address - Country:US
Practice Address - Phone:202-559-5119
Practice Address - Fax:202-727-0857
Is Sole Proprietor?:No
Enumeration Date:2010-04-12
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3008041041C0700X
DCLMFT000119106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist