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NPI Code Detail

MEDICARE: MS. ELIZABETH P. KOONTZ LCSW-C

MEDICARE:  MS. ELIZABETH P. KOONTZ  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 Worker11091MD

General Provider Information

NPI Number : 1497930911
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH P. KOONTZ LCSW-C
Provider Business Mailing Address
First Line : FAMILY SERVICE FOUNDATION,INC 5301 76TH AVE
Second Line :
City : LANDOVER HILLS
State : MD
Zip : 20784
Country : US
Telephone Number : 301-459-2121
Fax Number : 301-459-0675
Provider Business Practice Location Address
First Line : 5301 76TH AVE
Second Line :
City : LANDOVER HILLS
State : MD
Zip : 20784-1703
Country : US
Telephone Number : 301-459-2121
Fax Number : 301-459-0675
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2008
Last Update Date : 01/03/2008

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Directions to “ MS. ELIZABETH P. KOONTZ LCSW-C” Practice Location

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