| Lionhearts Unlimited, Llc | |
|
2036 W North Avenue Baltimore MD 21217 | |
| (443) 977-3048 | |
| Not Available |
| Full Name | Lionhearts Unlimited, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2036 W North Avenue, Baltimore, Maryland |
| Authorized Official Name and Position | Andrew M. Forday-watson (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4435641286 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lionhearts Unlimited, Llc 1451 Dartmouth Ave Parkville MD 21234-5901 Ph: (443) 564-1286 | Lionhearts Unlimited, Llc 2036 W North Avenue Baltimore MD 21217 Ph: (443) 977-3048 |
| NPI Number | 1588301196 |
|---|---|
| Provider Enumeration Date | 05/16/2022 |
| Last Update Date | 05/16/2022 |
| Certification Date | 05/16/2022 |
| Medicare PECOS PAC ID | 0749657757 |
|---|---|
| Medicare Enrollment ID | O20221104000011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588301196 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Andrew Musa Forday-watson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013522762 PECOS PAC ID: 1658748660 Enrollment ID: I20221104000016 |
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