Healthcare Provider Details

I. General information

NPI: 1245096429
Provider Name (Legal Business Name): MELANIE FROEMKE, LCSW, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2024
Last Update Date: 02/26/2024
Certification Date: 02/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 ORONOCO ST
ALEXANDRIA VA
22314-2015
US

IV. Provider business mailing address

107 ORONOCO ST
ALEXANDRIA VA
22314-2015
US

V. Phone/Fax

Practice location:
  • Phone: 703-283-8611
  • Fax:
Mailing address:
  • Phone: 703-283-8611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. MELANIE LYNN FROEMKE
Title or Position: THERAPIST, RPT-S
Credential: LCSW, RPT-S
Phone: 703-283-8611