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1548276322

NPI Code Detail

MEDICARE: BARBARA DOUGHERTY LCSW-C

MEDICARE: BARBARA DOUGHERTY 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
1	1041C0700X	Clinical Social Worker	07858	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2164119	OTHER	MD	MAMSI
2	533125	OTHER	MD	CAREFIRST BCBS-MD
3	7121376	OTHER	MD	AETNA BAHAVIORAL HEALTH
4	PVPB123502	OTHER	MD	APS HEALTHCARE
5	T541 0004	OTHER	MD	CAREFIRST BCBS-DC
6	226087	OTHER	MD	KAISER

General Provider Information

NPI Number	:	1548276322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA DOUGHERTY LCSW-C

Provider Business Mailing Address
First Line	:	4623 FALLS RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21209-4914
Country	:	US
Telephone Number	:	410-366-1980
Fax Number	:	410-366-8530

Provider Business Practice Location Address
First Line	:	10451 TWIN RIVERS RD
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-2388
Country	:	US
Telephone Number	:	410-997-3557
Fax Number	:	410-964-1791

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	11/26/2007

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Practice Location Address:

10451 TWIN RIVERS RD , SUITE 100
COLUMBIA, MD
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Practice Phone: 410-997-3557
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1962427963 — ILENE S GALLNER-TOLLER LCSW-C
Practice Location Address:

10451 TWIN RIVERS RD
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Practice Phone: 410-977-3557
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1346266582 — DOLORES MADIOU LCSW-C
Practice Location Address:

10451 TWIN RIVERS RD
COLUMBIA, MD
21044-2388

Practice Phone: 410-997-3557
Practice Fax: 410-964-1791

1053327742 — RONA LEVI LCSW-C
Practice Location Address:

10451 TWIN RIVERS RD
COLUMBIA, MD
21044-2388

Practice Phone: 410-997-3557
Practice Fax: 410-964-1791

1841304300 — JANE E JOFFE LCSW-C
Practice Location Address:

10451 TWIN RIVERS RD
COLUMBIA, MD
21044-2388

Practice Phone: 410-997-3557
Practice Fax: 410-964-1791

1093817983 — SAMUEL GOLDBERG MD
Practice Location Address:

10451 TWIN RIVERS RD
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21044-2388

Practice Phone: 410-997-3557
Practice Fax: 410-964-1791

Directions to “ BARBARA DOUGHERTY LCSW-C” Practice Location

Language	Start Address	Practice Location

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