MEDICARE: MR. MITCHELL J MARGOLIS LCSWC

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	02769	MD

General Provider Information

NPI Number	:	1669489993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MITCHELL J MARGOLIS LCSWC

Provider Business Mailing Address
First Line	:	9929 MAIN ST STE C
Second Line	:
City	:	DAMASCUS
State	:	MD
Zip	:	20872-2068
Country	:	US
Telephone Number	:	301-963-6050
Fax Number	:	301-963-6050

Provider Business Practice Location Address
First Line	:	9929 MAIN ST STE C
Second Line	:
City	:	DAMASCUS
State	:	MD
Zip	:	20872-2068
Country	:	US
Telephone Number	:	301-963-6050
Fax Number	:	301-765-2273

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	02/06/2026

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