MEDICARE: MRS. MELISSA K LINTHICUM LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LC12362	MD

General Provider Information

NPI Number	:	1861131773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELISSA K LINTHICUM LCPC

Provider Business Mailing Address
First Line	:	106 W MAPLE RD
Second Line	:
City	:	LINTHICUM HTS
State	:	MD
Zip	:	21090-2431
Country	:	US
Telephone Number	:	410-210-6911
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 W MAPLE RD
Second Line	:
City	:	LINTHICUM HTS
State	:	MD
Zip	:	21090-2431
Country	:	US
Telephone Number	:	410-210-6911
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2022
Last Update Date	:	05/09/2023

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