MEDICARE: ANNE DEGIROLAMO 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
1	1041C0700X	Clinical Social Worker	LC50078403	DC

General Provider Information

NPI Number	:	1831476274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE DEGIROLAMO LICSW

Provider Business Mailing Address
First Line	:	1338 NORTH CAPITOL STREET, NW
Second Line	:	SUITE 201
City	:	WASHINGTON
State	:	DC
Zip	:	20002
Country	:	US
Telephone Number	:	202-745-0073
Fax Number	:

Provider Business Practice Location Address
First Line	:	1338 NORTH CAPITOL STREET, NW
Second Line	:	SUITE 201
City	:	WASHINGTON
State	:	DC
Zip	:	20002
Country	:	US
Telephone Number	:	202-745-0073
Fax Number	:

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

Provider Enumeration Date	:	11/14/2011
Last Update Date	:	11/14/2011

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