MEDICARE: ARIANA FARR BELDOCH 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	104100000X	Social Worker	LG50081487	DC
2	104100000X	Social Worker	20836	MD
3	1041C0700X	Clinical Social Worker	20836	MD

General Provider Information

NPI Number	:	1861867079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIANA FARR BELDOCH LCSW-C

Provider Business Mailing Address
First Line	:	6345 EXECUTIVE BLVD
Second Line	:
City	:	NORTH BETHESDA
State	:	MD
Zip	:	20852-3905
Country	:	US
Telephone Number	:	301-447-7772
Fax Number	:

Provider Business Practice Location Address
First Line	:	6345 EXECUTIVE BLVD
Second Line	:
City	:	NORTH BETHESDA
State	:	MD
Zip	:	20852-3905
Country	:	US
Telephone Number	:	240-447-7772
Fax Number	:

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

Provider Enumeration Date	:	12/14/2015
Last Update Date	:	06/13/2019

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