MEDICARE: MACKAYLA HARRINGTON LGSW

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	1041S0200X	School Social Worker	LG200002807	DC

General Provider Information

NPI Number	:	1518723485
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACKAYLA HARRINGTON LGSW

Provider Business Mailing Address
First Line	:	3003 VAN NESS ST NW APT W1118
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20008-4808
Country	:	US
Telephone Number	:	202-480-9250
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 MISSISSIPPI AVE SE FL 3
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-6124
Country	:	US
Telephone Number	:	202-480-9250
Fax Number	:

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

Provider Enumeration Date	:	02/27/2024
Last Update Date	:	02/27/2024

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