MEDICARE: MS. LASHONDRA MONIQUE LOVE

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	104100000X	Social Worker	44SL06855000	NJ
2	104100000X	Social Worker	LSW.0009923822	CO
3	104100000X	Social Worker	26843	MD
4	104100000X	Social Worker	LG50083542	DC

General Provider Information

NPI Number	:	1033816715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LASHONDRA MONIQUE LOVE

Provider Business Mailing Address
First Line	:	1151 46TH PL SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-4939
Country	:	US
Telephone Number	:	305-988-6046
Fax Number	:

Provider Business Practice Location Address
First Line	:	1151 46TH PL SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-4939
Country	:	US
Telephone Number	:	305-988-6046
Fax Number	:

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

Provider Enumeration Date	:	02/13/2023
Last Update Date	:	02/13/2023

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