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NPI Code Detail

MEDICARE: NICOLE CATHERINE AVALLONE LCSW, LICSW

MEDICARE: NICOLE CATHERINE AVALLONE LCSW, LICSW
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 WorkerLC200001554DC
21041C0700XClinical Social Worker73 080781NY

General Provider Information

NPI Number : 1881028942
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE CATHERINE AVALLONE LCSW, LICSW
Provider Business Mailing Address
First Line : 10770 COLUMBIA PIKE STE 300
Second Line :
City : SILVER SPRING
State : MD
Zip : 20901-4439
Country : US
Telephone Number : 718-812-1272
Fax Number :
Provider Business Practice Location Address
First Line : 10770 COLUMBIA PIKE STE 300
Second Line :
City : SILVER SPRING
State : MD
Zip : 20901-4439
Country : US
Telephone Number : 718-812-1272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2013
Last Update Date : 01/30/2025

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