MEDICARE: MS. SAFI KHADIJA LYNCH L.C.S.W.-CLINICAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	15843	MD

General Provider Information

NPI Number	:	1003034158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SAFI KHADIJA LYNCH L.C.S.W.-CLINICAL

Provider Business Mailing Address
First Line	:	PO BOX 244
Second Line	:
City	:	CHELTENHAM
State	:	MD
Zip	:	20623-0244
Country	:	US
Telephone Number	:	301-613-6808
Fax Number	:

Provider Business Practice Location Address
First Line	:	9701 APOLLO DR
Second Line	:	SUITE 391
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-4783
Country	:	US
Telephone Number	:	301-583-1181
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	11/17/2012

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