Mellott, Gwendolyn
Mellott, Gwendolyn is an individual health care provider with primary practice located at 13215 Brook Lane , Hagerstown MD 21742-1514. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Mellott, Gwendolyn can be contacted via phone (301) 733-0331.Contact Information
Primary practice address
13215 Brook Lane
Hagerstown MD 21742-1514
Phone: (301) 733-0331
Fax: (301) 733-4038
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 10663 | Maryland |
Profile Details
| NPI number | 1124094602 |
|---|---|
| LBN Legal business name | Mellott, Gwendolyn |
| Credentials | LCSWC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 24th, 2006 |
| Last updated | Feb 20th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124094602 | NPPES |
| Maryland | MEDICAID | 986965400 |
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