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General NPI Number Information
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NPI Number | 1659485910
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Entity Type | Individual
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Provider Name | JOLIE GOLOMB LCSW,LICSW
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Gender | Female
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 12/04/2010
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Provider Practice Location Address
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Address Line | 4405 E WEST HWY SUITE 506
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City | BETHESDA
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State | MD
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Zip | 20814-4522
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Country | US
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Telephone | 301-961-9220
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Fax | 301-656-2998
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Provider Business Mailing Address
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Address Line | 5129 SCARSDALE RD
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City | BETHESDA
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State | MD
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Zip | 20816-2320
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Country | US
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Telephone | 301-320-3719
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Fax | 301-565-2998
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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 | LC302937
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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 | 09277
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | RO30051-1
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License Number State | NY
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