Provider Demographics
NPI:1669489993
Name:MARGOLIS, MITCHELL J (LCSWC)
Entity Type:Individual
Prefix:MR
First Name:MITCHELL
Middle Name:J
Last Name:MARGOLIS
Suffix:
Gender:M
Credentials:LCSWC
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Other - Credentials:
Mailing Address - Street 1:13 EAST DEER PARK RD
Mailing Address - Street 2:B
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2014
Mailing Address - Country:US
Mailing Address - Phone:301-963-6050
Mailing Address - Fax:301-963-6050
Practice Address - Street 1:13 EAST DEER PARK RD
Practice Address - Street 2:B
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2014
Practice Address - Country:US
Practice Address - Phone:301-963-6050
Practice Address - Fax:301-963-6050
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD02769104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker