Healthcare Provider Details

I. General information

NPI: 1124916515
Provider Name (Legal Business Name): VERONICA KIM MUSIOL LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2025
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 BAY RIDGE AVE STE 190
ANNAPOLIS MD
21403-2834
US

IV. Provider business mailing address

201 W CHESTNUT ST
PASADENA MD
21122-4362
US

V. Phone/Fax

Practice location:
  • Phone: 443-281-9430
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number30810
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: