MEDICARE: PRN COUNSELING

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	14200	MD

General Provider Information

NPI Number	:	1770035727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRN COUNSELING

Provider Business Mailing Address
First Line	:	6236 MONTROSE RD
Second Line	:
City	:	NORTH BETHESDA
State	:	MD
Zip	:	20852-4119
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6236 MONTROSE RD
Second Line	:
City	:	NORTH BETHESDA
State	:	MD
Zip	:	20852-4119
Country	:	US
Telephone Number	:	301-908-0353
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PAMELA NEWMAN
Credential	:	LCSW-C
Telephone Number	:	301-908-0353

Provider Enumeration Date	:	10/25/2016
Last Update Date	:	10/25/2016

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