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NPI Code Detail

MEDICARE: MR. JOSE CARLOS VERA II LCSW-C

MEDICARE: MR. JOSE CARLOS VERA II LCSW-C
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
11041C0700XClinical Social Worker11950MD
21041C0700XClinical Social WorkerDC LC303654DC

General Provider Information

NPI Number : 1154509123
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSE CARLOS VERA II LCSW-C
Provider Business Mailing Address
First Line : 7474 GREENWAY CENTER DR STE 730
Second Line :
City : GREENBELT
State : MD
Zip : 20770-3523
Country : US
Telephone Number : 301-345-1022
Fax Number : 301-560-5558
Provider Business Practice Location Address
First Line : 7474 GREENWAY CENTER DR STE 730
Second Line :
City : GREENBELT
State : MD
Zip : 20770-3523
Country : US
Telephone Number : 301-345-1022
Fax Number : 301-560-5558
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2008
Last Update Date : 11/09/2017

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