Healthcare Provider Details

I. General information

NPI: 1700385598
Provider Name (Legal Business Name): RINA PHILLIPS LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2018
Last Update Date: 02/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 COLESVILLE RD # 5
SILVER SPRING MD
20901-2335
US

IV. Provider business mailing address

10000 COLESVILLE RD
SILVER SPRING MD
20901-2335
US

V. Phone/Fax

Practice location:
  • Phone: 301-960-8960
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: