MEDICARE: MS. DAWN M ANDERSON 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	LC50077983	DC
2	1041C0700X	Clinical Social Worker	12716	MD

General Provider Information

NPI Number	:	1184643918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DAWN M ANDERSON LCSW-C

Provider Business Mailing Address
First Line	:	2101 E JEFFERSON ST
Second Line	:	KAISER PERMANENTE MEDICARE ENROLLMENT
City	:	ROCKVILLE
State	:	MD
Zip	:	20852-4908
Country	:	US
Telephone Number	:	301-816-2424
Fax Number	:

Provider Business Practice Location Address
First Line	:	5100 AUTH WAY
Second Line	:	KAISER PERMANENTE MARLOW HEIGHTS MEDICAL CENTER
City	:	SUITLAND
State	:	MD
Zip	:	20746-4207
Country	:	US
Telephone Number	:	301-702-5000
Fax Number	:

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	05/28/2021

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