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General NPI Number Information
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NPI Number | 1265979264
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Entity Type | Organization
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Legal Business Name | SOCIAL WORK CONSULTING AND CASE MANAGMENT SERVICES
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Dates
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Enumeration Date | 01/27/2017
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Last Update Date | 01/27/2017
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Provider Practice Location Address
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Address Line | 5056 KIMI GRAY CT SE
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City | WASHINGTON
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State | DC
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Zip | 20019-5915
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Country | US
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Telephone | 202-556-9235
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Fax |
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Provider Business Mailing Address
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Address Line | 5056 KIMI GRAY CT SE
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City | WASHINGTON
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State | DC
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Zip | 20019-5915
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Country | US
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Telephone | 202-556-9235
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | TRACY HAMILTON
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Credential | LICSW
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Telephone | 202-556-9235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC50080467
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License Number State | DC
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