MEDICARE: MARY ELIZABETH MULHOLLAND 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	09154	MD

General Provider Information

NPI Number	:	1144305087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ELIZABETH MULHOLLAND LCSW-C

Provider Business Mailing Address
First Line	:	15107 INTERLACHEN DR
Second Line	:	APT. 1006
City	:	SILVER SPRING
State	:	MD
Zip	:	20906-5625
Country	:	US
Telephone Number	:	301-598-5295
Fax Number	:

Provider Business Practice Location Address
First Line	:	15107 INTERLACHEN DR
Second Line	:	APT. 1006
City	:	SILVER SPRING
State	:	MD
Zip	:	20906-5625
Country	:	US
Telephone Number	:	301-598-5295
Fax Number	:

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

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	11/18/2015

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