MEDICARE: JADA MCCRAY 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	17354	MD

General Provider Information

NPI Number	:	1790944619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JADA MCCRAY LCSW-C

Provider Business Mailing Address
First Line	:	1001 CROMWELL BRIDGE RD
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21286-3300
Country	:	US
Telephone Number	:	410-337-5523
Fax Number	:	410-337-5576

Provider Business Practice Location Address
First Line	:	1001 CROMWELL BRIDGE RD
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21286-3300
Country	:	US
Telephone Number	:	410-337-5523
Fax Number	:	410-337-5576

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

Provider Enumeration Date	:	06/05/2008
Last Update Date	:	02/09/2012

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