MEDICARE: EILIS MCDONNELL

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	101YP2500X	Professional Counselor	LGP15742	MD

General Provider Information

NPI Number	:	1922829464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EILIS MCDONNELL

Provider Business Mailing Address
First Line	:	4405 E WEST HWY STE 601
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-4537
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4405 E WEST HWY STE 601
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-4537
Country	:	US
Telephone Number	:	301-477-0473
Fax Number	:

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

Provider Enumeration Date	:	10/17/2024
Last Update Date	:	10/17/2024

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Directions to “ EILIS MCDONNELL ” Practice Location

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