Healthcare Provider Details

I. General information

NPI: 1952279671
Provider Name (Legal Business Name): MOANNE JOSEPH LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 POST OFFICE RD STE 307
WALDORF MD
20602-1914
US

IV. Provider business mailing address

603 POST OFFICE RD STE 307
WALDORF MD
20602-1914
US

V. Phone/Fax

Practice location:
  • Phone: 202-664-4555
  • Fax:
Mailing address:
  • Phone: 202-664-4555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number31769
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: