MEDICARE: KATELYN ALCAMO 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	LGM350	MD
2	106H00000X	Marriage & Family Therapist	LCM401	MD

General Provider Information

NPI Number	:	1013239680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN ALCAMO LCMFT

Provider Business Mailing Address
First Line	:	9603 MONTGOMERY DR
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-1717
Country	:	US
Telephone Number	:	410-591-5126
Fax Number	:

Provider Business Practice Location Address
First Line	:	5654 SHIELDS DR
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20817-3574
Country	:	US
Telephone Number	:	240-600-0968
Fax Number	:

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

Provider Enumeration Date	:	02/23/2010
Last Update Date	:	11/29/2021

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