MEDICARE: MC THERAPY LLC

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

General Provider Information

NPI Number	:	1154216968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MC THERAPY LLC

Provider Business Mailing Address
First Line	:	200 WASHINGTON AVE FL 5-NO18
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21204-4718
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 WASHINGTON AVE FL 5
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21204-4718
Country	:	US
Telephone Number	:	410-339-8269
Fax Number	:

Authorized Official
Title or Position	:	LICENSED CLINICAL SOCIAL WORKER
Name	:	MICHELLE CHUNG
Credential	:
Telephone Number	:	410-267-3484

Provider Enumeration Date	:	06/11/2025
Last Update Date	:	06/11/2025

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Directions to “MC THERAPY LLC ” Practice Location

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