MEDICARE: KELDENE SMALL

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	21153	MD

General Provider Information

NPI Number	:	1508278862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELDENE SMALL

Provider Business Mailing Address
First Line	:	7808 EMILYS WAY
Second Line	:
City	:	GREENBELT
State	:	MD
Zip	:	20770-2465
Country	:	US
Telephone Number	:	301-437-1297
Fax Number	:

Provider Business Practice Location Address
First Line	:	903 BRIGHTSEAT RD
Second Line	:
City	:	LANDOVER
State	:	MD
Zip	:	20785-4725
Country	:	US
Telephone Number	:	301-333-2980
Fax Number	:

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

Provider Enumeration Date	:	05/21/2014
Last Update Date	:	08/15/2025

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Directions to “ KELDENE SMALL ” Practice Location

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