Basic Information
| Provider Information | |||||||||
| NPI: | 1790963767 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MCCOMB & ASSOCIATES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 711 WEST 40TH STREET | ||||||||
| Address2: | SUITE 427A | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212112120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102352881 | ||||||||
| FaxNumber: | 4102359339 | ||||||||
| Practice Location | |||||||||
| Address1: | 711 WEST 40TH STREET | ||||||||
| Address2: | SUITE 427A | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212112120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102352881 | ||||||||
| FaxNumber: | 4102359339 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2008 | ||||||||
| LastUpdateDate: | 11/26/2008 | ||||||||
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| AuthorizedOfficialLastName: | MCCOMB | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | KING | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4102352881 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | LCSW-C | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 4186 | MD | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.