MEDICARE: MS. JULIA CARROLL LUCORE LMSW

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	32049	MD

General Provider Information

NPI Number	:	1700616372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JULIA CARROLL LUCORE LMSW

Provider Business Mailing Address
First Line	:	4000 BLACKBURN LN
Second Line	:
City	:	BURTONSVILLE
State	:	MD
Zip	:	20866-1104
Country	:	US
Telephone Number	:	301-421-4241
Fax Number	:	410-696-3696

Provider Business Practice Location Address
First Line	:	4000 BLACKBURN LN
Second Line	:
City	:	BURTONSVILLE
State	:	MD
Zip	:	20866-1104
Country	:	US
Telephone Number	:	301-421-4241
Fax Number	:	410-696-3696

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

Provider Enumeration Date	:	08/07/2024
Last Update Date	:	08/07/2024

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