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NPI Code Detail

MEDICARE: DAVID SEMANCO MAC,CADC,CSAC,CAC-AD

MEDICARE: DAVID SEMANCO MAC,CADC,CSAC,CAC-AD
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1366944894
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID SEMANCO MAC,CADC,CSAC,CAC-AD
Provider Business Mailing Address
First Line : 15329 BARNABAS TRL
Second Line :
City : WOODBRIDGE
State : VA
Zip : 22193-5566
Country : US
Telephone Number : 571-264-1527
Fax Number :
Provider Business Practice Location Address
First Line : 2015 MARTINS GRANT CT
Second Line :
City : CROWNSVILLE
State : MD
Zip : 21032-1932
Country : US
Telephone Number : 410-721-6353
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2018
Last Update Date : 02/28/2018

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