MEDICARE: MISS CECILIA ESQUIVEL 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	11924	MD

General Provider Information

NPI Number	:	1285707497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CECILIA ESQUIVEL LCSW-C

Provider Business Mailing Address
First Line	:	8609 22ND PLACE
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20783-2154
Country	:	US
Telephone Number	:	301-806-4451
Fax Number	:	301-920-0491

Provider Business Practice Location Address
First Line	:	7034 CARROLL AVE
Second Line	:
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-4434
Country	:	US
Telephone Number	:	301-806-4451
Fax Number	:	301-920-0491

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

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	12/10/2011

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Directions to “ MISS CECILIA ESQUIVEL LCSW-C” Practice Location

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