MEDICARE: MS. MARGARET ANN MCCRAW 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	104100000X	Social Worker	03076	MD
2	1041C0700X	Clinical Social Worker	03076	MD
3	1041S0200X	School Social Worker	03076	MD
4	106H00000X	Marriage & Family Therapist	03076	MD

General Provider Information

NPI Number	:	1164964367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARGARET ANN MCCRAW LCSW-C

Provider Business Mailing Address
First Line	:	3831 YOLANDO RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21218-2044
Country	:	US
Telephone Number	:	410-366-9111
Fax Number	:	410-630-1021

Provider Business Practice Location Address
First Line	:	3831 YOLANDO RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21218-2044
Country	:	US
Telephone Number	:	410-366-9111
Fax Number	:	410-630-1021

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

Provider Enumeration Date	:	11/06/2016
Last Update Date	:	11/06/2016

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