MEDICARE: DILLON BROOKE MORRIGAN LCSW

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	14457	MD
2	1041C0700X	Clinical Social Worker	50078565	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	197929	OTHER		PTAN

General Provider Information

NPI Number	:	1972548501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DILLON BROOKE MORRIGAN LCSW

Provider Business Mailing Address
First Line	:	2202 RICHLAND PL
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-2331
Country	:	US
Telephone Number	:	202-319-7160
Fax Number	:

Provider Business Practice Location Address
First Line	:	8830 CAMERON ST
Second Line	:	SUITE 207
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-4114
Country	:	US
Telephone Number	:	202-329-7160
Fax Number	:

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

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	04/16/2014

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