MEDICARE: MRS. CHRISTINE G MCNAMARA LCSW

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	SW 9909	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SW 9909	OTHER	FL	DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE

General Provider Information

NPI Number	:	1649581356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINE G MCNAMARA LCSW

Provider Business Mailing Address
First Line	:	10704 OUT ISLAND DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-2521
Country	:	US
Telephone Number	:	813-382-1485
Fax Number	:

Provider Business Practice Location Address
First Line	:	6710 EMBASSY BLVD
Second Line	:	STE #202
City	:	PORT RICHEY
State	:	FL
Zip	:	34668-7754
Country	:	US
Telephone Number	:	813-382-1485
Fax Number	:

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

Provider Enumeration Date	:	06/28/2010
Last Update Date	:	06/28/2010

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