Provider Demographics
NPI:1275898751
Name:MUIR, ODELIA (LCSW-C, LICSW)
Entity Type:Individual
Prefix:
First Name:ODELIA
Middle Name:
Last Name:MUIR
Suffix:
Gender:F
Credentials:LCSW-C, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13184 LARCHDALE RD
Mailing Address - Street 2:APT #6
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1707
Mailing Address - Country:US
Mailing Address - Phone:202-489-2066
Mailing Address - Fax:877-409-9940
Practice Address - Street 1:13184 LARCHDALE RD
Practice Address - Street 2:APT #6
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1707
Practice Address - Country:US
Practice Address - Phone:202-489-2066
Practice Address - Fax:877-409-9940
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19640101YM0800X, 106H00000X, 1041C0700X, 101YP2500X, 101YA0400X
DCLC500802411041C0700X, 106H00000X, 101YP2500X, 101YM0800X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)