MEDICARE: MRS. FRANCESS BAINDU SONGU I CSW

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	101YS0200X	School Counselor
2	171M00000X	Case Manager/Care Coordinator

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NA	OTHER		NA

General Provider Information

NPI Number	:	1124735956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FRANCESS BAINDU SONGU I CSW

Provider Business Mailing Address
First Line	:	12106 WESTLOCK PL
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20708-2422
Country	:	US
Telephone Number	:	619-831-7597
Fax Number	:

Provider Business Practice Location Address
First Line	:	12106 WESTLOCK PL
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20708-2422
Country	:	US
Telephone Number	:	240-302-1258
Fax Number	:

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

Provider Enumeration Date	:	11/01/2022
Last Update Date	:	05/22/2023

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