MEDICARE: KATHRYN ULRICH TSAI 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	06106	MD

General Provider Information

NPI Number	:	1366772824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN ULRICH TSAI LCSW-C

Provider Business Mailing Address
First Line	:	4942 REEDY BROOK LN
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-1514
Country	:	US
Telephone Number	:	410-997-7171
Fax Number	:	410-730-9222

Provider Business Practice Location Address
First Line	:	4942 REEDY BROOK LN
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-1514
Country	:	US
Telephone Number	:	410-997-7171
Fax Number	:	410-730-9222

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

Provider Enumeration Date	:	01/06/2010
Last Update Date	:	01/06/2010

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