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General NPI Number Information
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NPI Number | 1427364108
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Entity Type | Individual
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Provider Name | IHSAN S. OMAR LCSW-C, CST
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Gender | Female
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Dates
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Enumeration Date | 08/19/2010
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | 1707 ROSEMONT AVE.
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City | FREDERICK
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State | MD
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Zip | 21702
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Country | US
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Telephone | 240-454-5647
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Fax | 240-474-9172
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Provider Business Mailing Address
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Address Line | 1707 ROSEMONT AVE.
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City | FREDERICK
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State | MD
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Zip | 21702
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Country | US
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Telephone | 240-454-5647
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Fax | 240-474-9172
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | LC50077903
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 13172
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License Number State | MD
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