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NPI Code Detail

MEDICARE: MISS ELBA JOANNA RIVAS RETANA LCSW-C

MEDICARE:  MISS ELBA JOANNA RIVAS RETANA  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
11041C0700XClinical Social Worker20229MD

General Provider Information

NPI Number : 1669981320
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ELBA JOANNA RIVAS RETANA LCSW-C
Provider Business Mailing Address
First Line : 8709 FLOWER AVE
Second Line :
City : SILVER SPRING
State : MD
Zip : 20901-4035
Country : US
Telephone Number : 301-422-5904
Fax Number :
Provider Business Practice Location Address
First Line : 8709 FLOWER AVE
Second Line :
City : SILVER SPRING
State : MD
Zip : 20901-4035
Country : US
Telephone Number : 301-422-5904
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2017
Last Update Date : 09/26/2017

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Directions to “ MISS ELBA JOANNA RIVAS RETANA LCSW-C” Practice Location

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