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NPI Code Detail

MEDICARE: MISS ELIZABETH CORSON MOHLER LICSW

MEDICARE: MISS ELIZABETH CORSON MOHLER LICSW
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
1171M00000XCase Manager/Care CoordinatorDC
21041C0700XClinical Social WorkerLCS23709CA

General Provider Information

NPI Number : 1740311851
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ELIZABETH CORSON MOHLER LICSW
Provider Business Mailing Address
First Line : 2005 CHEREMOYA AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90068-3552
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1419 COLUMBIA RD NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20009-4705
Country : US
Telephone Number : 202-489-4906
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2007
Last Update Date : 08/07/2024

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