MEDICARE: MS. DEBORAH ALISON NEWMARK MSSA

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	LC300191	DC
2	1041C0700X	Clinical Social Worker	03969	MD

General Provider Information

NPI Number	:	1447330105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBORAH ALISON NEWMARK MSSA

Provider Business Mailing Address
First Line	:	2121 OBSERVATORY PL NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20007-1812
Country	:	US
Telephone Number	:	202-338-1086
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 OBSERVATORY PL NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20007-1812
Country	:	US
Telephone Number	:	202-338-1086
Fax Number	:

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	07/08/2007

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