MEDICARE: MS. KARLA JEAN ABNEY 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	1041C0700X	Clinical Social Worker	LG200001571	DC
2	1041C0700X	Clinical Social Worker	28790	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	28790	OTHER	MD	MD MASTER SOCIAL WORK LICENSE
2	LG200001571	OTHER	DC	GRADUATE CLINICAL SOCIAL WORK LICENSE

General Provider Information

NPI Number	:	1215012745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KARLA JEAN ABNEY LGSW, LMSW

Provider Business Mailing Address
First Line	:	610 E DIAMOND AVE STE 100
Second Line	:
City	:	GAITHERSBURG
State	:	MD
Zip	:	20877-5321
Country	:	US
Telephone Number	:	410-840-3200
Fax Number	:

Provider Business Practice Location Address
First Line	:	610 E DIAMOND AVE STE 100
Second Line	:
City	:	GAITHERSBURG
State	:	MD
Zip	:	20877-5321
Country	:	US
Telephone Number	:	410-840-3200
Fax Number	:

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	09/01/2022

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