| Samuel T Bolin Jr Lcsw-c, Llc | |
|
939 Elkridge Landing Rd Ste 350 Linthicum MD 21090-2909 | |
| (443) 588-8753 | |
| Not Available |
| Full Name | Samuel T Bolin Jr Lcsw-c, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 939 Elkridge Landing Rd Ste 350, Linthicum, Maryland |
| Authorized Official Name and Position | Samuel Todd Bolin (OWNER) |
| Authorized Official Contact | 4433100466 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel T Bolin Jr Lcsw-c, Llc 1013 Bluebells Rd Gambrills MD 21054-2059 Ph: (443) 310-0466 | Samuel T Bolin Jr Lcsw-c, Llc 939 Elkridge Landing Rd Ste 350 Linthicum MD 21090-2909 Ph: (443) 588-8753 |
| NPI Number | 1578091583 |
|---|---|
| Provider Enumeration Date | 06/03/2017 |
| Last Update Date | 11/12/2021 |
| Certification Date | 11/12/2021 |
| Medicare PECOS PAC ID | 7810266939 |
|---|---|
| Medicare Enrollment ID | O20170706000090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578091583 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 20697 (Maryland) | Primary |
| Provider Name | Samuel Todd Bolin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598175648 PECOS PAC ID: 9638448756 Enrollment ID: I20170706000144 |
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