MEDICARE: MS. DENISE LAVERNE TROTTER GLYNN 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	09850	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	09850	OTHER	MD	LCSW-C

General Provider Information

NPI Number	:	1649488834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DENISE LAVERNE TROTTER GLYNN LCSW-C

Provider Business Mailing Address
First Line	:	1300 MERCANTILE LN
Second Line	:
City	:	LARGO
State	:	MD
Zip	:	20774-5327
Country	:	US
Telephone Number	:	301-512-4689
Fax Number	:	301-773-1052

Provider Business Practice Location Address
First Line	:	721 E PATAPSCO AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21225-1934
Country	:	US
Telephone Number	:	301-512-4689
Fax Number	:	301-773-1052

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

Provider Enumeration Date	:	05/19/2007
Last Update Date	:	01/27/2014

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