Healthcare Provider Details

I. General information

NPI: 1093149098
Provider Name (Legal Business Name): MELISSA YVONNE WRIGHT-POWELL LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2013
Last Update Date: 08/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 MAURY RD
BALTIMORE MD
21244-4002
US

IV. Provider business mailing address

7500 MAURY RD
BALTIMORE MD
21244-4002
US

V. Phone/Fax

Practice location:
  • Phone: 443-763-0162
  • Fax: 443-388-9367
Mailing address:
  • Phone: 443-763-0162
  • Fax: 443-388-9367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number09719
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: