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NPI Code Detail

MEDICARE: MRS. CARMEN MILES DAVIS LCSW-C

MEDICARE: MRS. CARMEN MILES DAVIS 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 Worker14803MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801037015
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CARMEN MILES DAVIS LCSW-C
Provider Business Mailing Address
First Line : 7007 PLYMOUTH RD
Second Line :
City : PIKESVILLE
State : MD
Zip : 21208-6023
Country : US
Telephone Number : 301-503-5696
Fax Number :
Provider Business Practice Location Address
First Line : 3355 SAINT JOHNS LN
Second Line : STE F
City : ELLICOTT CITY
State : MD
Zip : 21042-2600
Country : US
Telephone Number : 301-503-5696
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2009
Last Update Date : 11/19/2016

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