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NPI Code Detail

MEDICARE: KELLY ELIZABETH MCCABE LCSW-C

MEDICARE: KELLY ELIZABETH MCCABE 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
1104100000XSocial Worker23586MD

General Provider Information

NPI Number : 1467005298
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY ELIZABETH MCCABE LCSW-C
Provider Business Mailing Address
First Line : 5163 HARPERS FARM RD
Second Line :
City : COLUMBIA
State : MD
Zip : 21044-5710
Country : US
Telephone Number : 410-929-7978
Fax Number :
Provider Business Practice Location Address
First Line : 5163 HARPERS FARM RD
Second Line :
City : COLUMBIA
State : MD
Zip : 21044-5710
Country : US
Telephone Number : 410-929-7976
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2019
Last Update Date : 03/01/2021

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Directions to “ KELLY ELIZABETH MCCABE LCSW-C” Practice Location

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