Provider Demographics
NPI:1710027552
Name:HOMON, PAUL PATRICK (LCSW-C)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:PATRICK
Last Name:HOMON
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 1:18028 BILNEY DR
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-2831
Mailing Address - Country:US
Mailing Address - Phone:301-570-5531
Mailing Address - Fax:
Practice Address - Street 1:932 HUNGERFORD DR STE 36B
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1753
Practice Address - Country:US
Practice Address - Phone:301-570-7597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD083471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical