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General NPI Number Information
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NPI Number | 1700493012
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Entity Type | Individual
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Provider Name | MELISSA HERENDEEN LMSW
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Gender | Female
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Dates
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Enumeration Date | 09/30/2020
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Last Update Date | 09/30/2020
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Provider Practice Location Address
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Address Line | 7979 OLD GEORGETOWN RD FL 1
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City | BETHESDA
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State | MD
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Zip | 20814-2429
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Country | US
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Telephone | 855-435-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 1822 41ST PL SE
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City | WASHINGTON
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State | DC
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Zip | 20020-6022
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Country | US
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Telephone | 727-255-3021
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 25872
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License Number State | MD
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