MEDICARE: TANIA M HIRALDO-MELENDEZ LCPC, NCC, BC-TMH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LC5489	MD

General Provider Information

NPI Number	:	1871855247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANIA M HIRALDO-MELENDEZ LCPC, NCC, BC-TMH

Provider Business Mailing Address
First Line	:	1425 UNIVERSITY BLVD E STE 245
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20783-4646
Country	:	US
Telephone Number	:	240-752-2707
Fax Number	:

Provider Business Practice Location Address
First Line	:	1425 UNIVERSITY BLVD E STE 245
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20783-4646
Country	:	US
Telephone Number	:	240-752-2767
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2012
Last Update Date	:	04/17/2019

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