MEDICARE: ELLA M EDELMAN LCSW

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	23921	MD

General Provider Information

NPI Number	:	1023843216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLA M EDELMAN LCSW

Provider Business Mailing Address
First Line	:	6705 CHOKEBERRY RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21209-1403
Country	:	US
Telephone Number	:	443-481-7577
Fax Number	:

Provider Business Practice Location Address
First Line	:	6772 PALMETTO CIR S APT 101
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3516
Country	:	US
Telephone Number	:	443-481-7577
Fax Number	:

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

Provider Enumeration Date	:	09/05/2024
Last Update Date	:	02/04/2026

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