Healthcare Provider Details

I. General information

NPI: 1285707497
Provider Name (Legal Business Name): CECILIA ESQUIVEL LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 12/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7034 CARROLL AVE
TAKOMA PARK MD
20912-4434
US

IV. Provider business mailing address

8609 22ND PLACE
HYATTSVILLE MD
20783-2154
US

V. Phone/Fax

Practice location:
  • Phone: 301-806-4451
  • Fax: 301-920-0491
Mailing address:
  • Phone: 301-806-4451
  • Fax: 301-920-0491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11924
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: