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NPI Code Detail

MEDICARE: MARY B MITCHELL LCSWC

MEDICARE: MARY B MITCHELL LCSWC
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 Worker04634MD

General Provider Information

NPI Number : 1982787446
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY B MITCHELL LCSWC
Provider Business Mailing Address
First Line : 5301 76TH AVE
Second Line :
City : LANDOVER HILLS
State : MD
Zip : 20784-1703
Country : US
Telephone Number : 301-459-2121
Fax Number : 301-459-0675
Provider Business Practice Location Address
First Line : 5301 76TH AVE
Second Line :
City : LANDOVER HILLS
State : MD
Zip : 20784-1703
Country : US
Telephone Number : 301-459-2121
Fax Number : 301-459-0675
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2006
Last Update Date : 11/03/2011

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Directions to “ MARY B MITCHELL LCSWC” Practice Location

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