=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003962705
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HELENE TONEY CAIN L.C.S.W.-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/26/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8028 RITCHIE HWY SUITE 310
-----------------------------------------------------
City | PASADENA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21122-1075
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-768-3361
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2237 VILLAGE SQUARE RD
-----------------------------------------------------
City | FREDERICK
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21701-9381
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-698-8990
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 05904
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------