MEDICARE: MS. MARCIE CHADWICK CARMODY LGSW

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	LC50078153	DC

General Provider Information

NPI Number	:	1245393008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARCIE CHADWICK CARMODY LGSW

Provider Business Mailing Address
First Line	:	3100 CONNECTICUT AVE NW APT 143
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20008-5100
Country	:	US
Telephone Number	:	202-249-9300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1012 14TH ST NW STE 1400
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20005-3452
Country	:	US
Telephone Number	:	202-654-5141
Fax Number	:

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

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	07/08/2007

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