MEDICARE: PAULINE EZE LCSW-C

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	101YM0800X	Mental Health Counselor	14626	MD

General Provider Information

NPI Number	:	1023949807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULINE EZE LCSW-C

Provider Business Mailing Address
First Line	:	7054 HOLLY SPRINGS LN
Second Line	:
City	:	ELKRIDGE
State	:	MD
Zip	:	21075-6567
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7054 HOLLY SPRINGS LN
Second Line	:
City	:	ELKRIDGE
State	:	MD
Zip	:	21075-6567
Country	:	US
Telephone Number	:	240-383-9747
Fax Number	:

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

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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Directions to “ PAULINE EZE LCSW-C” Practice Location

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