Provider Demographics
NPI:1730560442
Name:BECKER, MELANIE (MSW)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:BECKER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 INDIAN SPRING DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-3018
Mailing Address - Country:US
Mailing Address - Phone:414-899-6621
Mailing Address - Fax:
Practice Address - Street 1:4405 E WEST HWY
Practice Address - Street 2:411
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4522
Practice Address - Country:US
Practice Address - Phone:414-899-6621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500798221041C0700X
MD194751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical