MEDICARE: MR. DAVID LEONARD TRAUTMANN L.C.S.W.

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	I-3971	NM

General Provider Information

NPI Number	:	1235113416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID LEONARD TRAUTMANN L.C.S.W.

Provider Business Mailing Address
First Line	:	7357 NICOLE MARIE CT
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22101-2730
Country	:	US
Telephone Number	:	571-655-7088
Fax Number	:

Provider Business Practice Location Address
First Line	:	1485 CHAIN BRIDGE RD.
Second Line	:	STE 304-A
City	:	MCLEAN
State	:	VA
Zip	:	22101-4501
Country	:	US
Telephone Number	:	703-634-9893
Fax Number	:

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

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	09/27/2020

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