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General NPI Number Information
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NPI Number | 1891157913
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Entity Type | Individual
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Provider Name | DAVID LYNN MYFORD LCSW
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Gender | Male
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Dates
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Enumeration Date | 03/28/2016
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 1020 PARK AVE APT 1209
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City | BALTIMORE
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State | MD
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Zip | 21201-5646
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Country | US
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Telephone | 312-883-6936
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 PARK AVE APT 1209
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City | BALTIMORE
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State | MD
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Zip | 21201-5646
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Country | US
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Telephone | 708-308-9064
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.015451
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License Number State | IL
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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 | 29318
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License Number State | MD
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