Provider Demographics
NPI:1437507050
Name:ABZUG, DANIEL (LCSW-C)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:ABZUG
Suffix:
Gender:M
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 1:817 SILVER SPRING AVE
Mailing Address - Street 2:#408
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4673
Mailing Address - Country:US
Mailing Address - Phone:301-960-8991
Mailing Address - Fax:
Practice Address - Street 1:817 SILVER SPRING AVE
Practice Address - Street 2:#408
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4673
Practice Address - Country:US
Practice Address - Phone:301-960-8991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-25
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD187441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical