MEDICARE: MS. JEANINE MARIA LAMB MSW, 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	1041C0700X	Clinical Social Worker	11035	MD
2	1041C0700X	Clinical Social Worker	LC3000812	DC

General Provider Information

NPI Number	:	1649351313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JEANINE MARIA LAMB MSW, LCSW-C

Provider Business Mailing Address
First Line	:	3000 CONNECTICUT AVE NW STE 237D
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20008-2531
Country	:	US
Telephone Number	:	301-518-6947
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 CONNECTICUT AVE NW STE 237D
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20008-2531
Country	:	US
Telephone Number	:	301-518-6947
Fax Number	:

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	01/08/2022

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