Healthcare Provider Details

I. General information

NPI: 1033153655
Provider Name (Legal Business Name): ROXANNE MELGAR LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6314 WINDSOR MILL RD SUITE 201
BALTIMORE MD
21207-6075
US

IV. Provider business mailing address

8824 BLAIRWOOD COURT B2
BALTIMORE MD
21236
US

V. Phone/Fax

Practice location:
  • Phone: 410-265-1154
  • Fax:
Mailing address:
  • Phone: 443-854-7595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11039
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: