MEDICARE: KARDIA DALEY LGSW, LMSW

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	LG50083391	DC

General Provider Information

NPI Number	:	1184385304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARDIA DALEY LGSW, LMSW

Provider Business Mailing Address
First Line	:	13028 CLARION RD
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-2816
Country	:	US
Telephone Number	:	845-853-2660
Fax Number	:

Provider Business Practice Location Address
First Line	:	13028 CLARION RD
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-2816
Country	:	US
Telephone Number	:	202-713-5568
Fax Number	:

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

Provider Enumeration Date	:	01/10/2022
Last Update Date	:	01/10/2022

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