MEDICARE: DANESHA SHAQUIL OWENS-HARRELL 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	24116	MD

General Provider Information

NPI Number	:	1952889453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANESHA SHAQUIL OWENS-HARRELL LCSW-C

Provider Business Mailing Address
First Line	:	3222 BELAIR RD STE 1
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21213-1278
Country	:	US
Telephone Number	:	443-292-2409
Fax Number	:

Provider Business Practice Location Address
First Line	:	3222 BELAIR RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21213-1278
Country	:	US
Telephone Number	:	443-292-2409
Fax Number	:

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

Provider Enumeration Date	:	08/06/2018
Last Update Date	:	10/06/2021

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