MEDICARE: MRS. KARLA PATE MCCLURE 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	28794	MD
2	104100000X	Social Worker	28794	MD

General Provider Information

NPI Number	:	1700505799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KARLA PATE MCCLURE LCSW-C

Provider Business Mailing Address
First Line	:	610 E. DIAMOND AVE., STE 100
Second Line	:
City	:	GAITHERSBURG
State	:	MD
Zip	:	20877-5321
Country	:	US
Telephone Number	:	301-840-3200
Fax Number	:

Provider Business Practice Location Address
First Line	:	610 E DIAMOND AVE STE 100
Second Line	:
City	:	GAITHERSBURG
State	:	MD
Zip	:	20877-5321
Country	:	US
Telephone Number	:	202-680-2903
Fax Number	:

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

Provider Enumeration Date	:	08/24/2022
Last Update Date	:	06/04/2026

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