Provider Demographics
NPI:1164440939
Name:LONDEREE, ADRIENNE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:LONDEREE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 LYTTONSVILLE RD APT 1517
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1936
Mailing Address - Country:US
Mailing Address - Phone:240-475-6411
Mailing Address - Fax:301-414-0476
Practice Address - Street 1:26005 RIDGE RD STE 200
Practice Address - Street 2:
Practice Address - City:DAMASCUS
Practice Address - State:MD
Practice Address - Zip Code:20872
Practice Address - Country:US
Practice Address - Phone:301-414-2300
Practice Address - Fax:301-414-0476
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD122011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD406971400Medicaid