Provider Demographics
NPI:1316963218
Name:MCCOMB, JOHN KING (LCSWC)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:KING
Last Name:MCCOMB
Suffix:
Gender:
Credentials:LCSWC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:711 W 40TH ST
Mailing Address - Street 2:STE 427A
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2120
Mailing Address - Country:US
Mailing Address - Phone:410-235-2881
Mailing Address - Fax:410-235-9339
Practice Address - Street 1:711 W 40TH ST
Practice Address - Street 2:STE 427A
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-2120
Practice Address - Country:US
Practice Address - Phone:410-235-2881
Practice Address - Fax:410-235-9339
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2025-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD41861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
372M512FMedicare ID - Type Unspecified