MEDICARE: MS. HANNAH WORTHINGTON LCMFT

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	106H00000X	Marriage & Family Therapist	LCM405	MD

General Provider Information

NPI Number	:	1013201342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HANNAH WORTHINGTON LCMFT

Provider Business Mailing Address
First Line	:	4600 DREXEL RD
Second Line	:
City	:	COLLEGE PARK
State	:	MD
Zip	:	20740-3604
Country	:	US
Telephone Number	:	301-277-7923
Fax Number	:

Provider Business Practice Location Address
First Line	:	7935 BELLE POINT DR
Second Line	:
City	:	GREENBELT
State	:	MD
Zip	:	20770-3329
Country	:	US
Telephone Number	:	240-486-0799
Fax Number	:

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

Provider Enumeration Date	:	06/03/2011
Last Update Date	:	06/03/2011

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