Lillian Yvonne Ingram, LICSW

Individual provider Active NPI Clinical Social Worker · Spencerville, MD

NPI 1013799329 · NPPES record last updated Oct 20, 2023

Key facts

NPI
1013799329
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LC300589 (DC)
Practice address
17013 Oak Hill Rd
Spencerville, MD 20868-3105
Phone
(202) 714-6012
NPI assigned
Oct 20, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LC300589DCMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC300589 DC Yes

Addresses

Primary practice location

17013 Oak Hill Rd
Spencerville, MD 20868-3105

Mailing address

17013 Oak Hill Rd
Spencerville, MD 20868-3105
Phone (202) 714-6012

Other providers in Spencerville, MD

All providers in Spencerville, MD · Clinical Social Worker in Maryland

Sources for this page

Verify at the official NPI Registry.