Healthcare Provider Details

I. General information

NPI: 1730311606
Provider Name (Legal Business Name): MELVIN MOSCHEL LCSW-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2009
Last Update Date: 08/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 N CALVERT ST SUITE 670
BALTIMORE MD
21218-2867
US

IV. Provider business mailing address

3333 N CALVERT ST SUITE 670
BALTIMORE MD
21218-2867
US

V. Phone/Fax

Practice location:
  • Phone: 410-933-9000
  • Fax: 410-933-9085
Mailing address:
  • Phone: 410-933-9000
  • Fax: 410-933-9085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13150
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: