MEDICARE: MS. CLARA E MUSSER 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	104100000X	Social Worker	18962	MD

General Provider Information

NPI Number	:	1467891135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CLARA E MUSSER LCSW-C

Provider Business Mailing Address
First Line	:	46940 S SHANGRI LA DR
Second Line	:	SUITE 15
City	:	LEXINGTON PARK
State	:	MD
Zip	:	20653-1037
Country	:	US
Telephone Number	:	301-863-4543
Fax Number	:

Provider Business Practice Location Address
First Line	:	46940 S SHANGRI LA DR
Second Line	:	SUITE 15
City	:	LEXINGTON PARK
State	:	MD
Zip	:	20653-1037
Country	:	US
Telephone Number	:	301-863-4543
Fax Number	:

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

Provider Enumeration Date	:	06/17/2013
Last Update Date	:	09/15/2015

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