MEDICARE: LYNNE G GREENWALD MSW

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	1041C0700X	Clinical Social Worker	LC300489	DC

General Provider Information

NPI Number	:	1275032708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNNE G GREENWALD MSW

Provider Business Mailing Address
First Line	:	4600 CONNECTICUT AVE NW STE 223
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20008-5702
Country	:	US
Telephone Number	:	202-321-9015
Fax Number	:

Provider Business Practice Location Address
First Line	:	4600 CONNECTICUT AVE NW STE 223
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20008-5702
Country	:	US
Telephone Number	:	202-321-9015
Fax Number	:

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

Provider Enumeration Date	:	02/10/2018
Last Update Date	:	02/10/2018

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