Healthcare Provider Details

I. General information

NPI: 1164440939
Provider Name (Legal Business Name): ADRIENNE LONDEREE LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 09/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26005 RIDGE RD STE 200
DAMASCUS MD
20872
US

IV. Provider business mailing address

2445 LYTTONSVILLE RD APT 1517
SILVER SPRING MD
20910-1936
US

V. Phone/Fax

Practice location:
  • Phone: 301-414-2300
  • Fax: 301-414-0476
Mailing address:
  • Phone: 240-475-6411
  • Fax: 301-414-0476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12201
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: