MEDICARE: MARY E. WOODS LCSW

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	8747	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285832980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY E. WOODS LCSW

Provider Business Mailing Address
First Line	:	1249 CLEARWOOD RD
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23238-4954
Country	:	US
Telephone Number	:	804-773-9972
Fax Number	:	804-773-9972

Provider Business Practice Location Address
First Line	:	1249 CLEARWOOD RD
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23238-4954
Country	:	US
Telephone Number	:	804-773-9972
Fax Number	:	804-773-9972

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

Provider Enumeration Date	:	07/05/2007
Last Update Date	:	09/22/2021

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