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NPI Code Detail

MEDICARE: SAMANTHA DRACUP LCSW-C

MEDICARE: SAMANTHA DRACUP 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
11041C0700XClinical Social Worker25240MD

General Provider Information

NPI Number : 1376278192
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA DRACUP LCSW-C
Provider Business Mailing Address
First Line : 2700 WASHINGTON AVE
Second Line :
City : HALETHORPE
State : MD
Zip : 21227-3115
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2700 WASHINGTON AVE
Second Line :
City : HALETHORPE
State : MD
Zip : 21227-3115
Country : US
Telephone Number : 667-600-2353
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2022
Last Update Date : 12/03/2025

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Directions to “ SAMANTHA DRACUP LCSW-C” Practice Location

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