Healthcare Provider Details

I. General information

NPI: 1346662871
Provider Name (Legal Business Name): MELANIE STARGELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2014
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2905 MITCHELLVILLE RD STE 204
BOWIE MD
20716-3961
US

IV. Provider business mailing address

7225 HANOVER PKWY STE C
GREENBELT MD
20770-2024
US

V. Phone/Fax

Practice location:
  • Phone: 301-701-6965
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC13678
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: