MEDICARE: SHELIZA SOPHIA INASI 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	1041C0700X	Clinical Social Worker	14409	MD

General Provider Information

NPI Number	:	1093412272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELIZA SOPHIA INASI LCSW-C

Provider Business Mailing Address
First Line	:	5100 BUCKEYSTOWN PIKE STE 250
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21704-8344
Country	:	US
Telephone Number	:	301-349-1091
Fax Number	:

Provider Business Practice Location Address
First Line	:	9528 STAR MOON LN
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20723-5754
Country	:	US
Telephone Number	:	301-996-2935
Fax Number	:

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

Provider Enumeration Date	:	02/08/2023
Last Update Date	:	02/03/2026

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