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General NPI Number Information
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NPI Number | 1578471454
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Entity Type | Individual
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Provider Name | CARLOS MORA LMSW
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Gender | Male
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 555 QUINCE ORCHARD RD # 250
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City | GAITHERSBURG
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State | MD
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Zip | 20878-1437
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Country | US
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Telephone | 484-202-0751
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Fax |
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Provider Business Mailing Address
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Address Line | 110 E DEER PARK DR
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City | GAITHERSBURG
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State | MD
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Zip | 20877-2031
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Country | US
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Telephone | 240-281-1661
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 31070
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License Number State | MD
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