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Nicole L Lee-Khalif

Social Worker

Behavioral Health & Social Service Providers

958 Joshua Tree Ct, Owings Mills, MD 21117-1756

PECOS Enrollment

This provider is enrolled in PECOS as NICOLE LEE-KHALIF.

Based on the most recent information from CMS, provider Nicole L Lee-Khalif is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 10:04 AM.

Profile Details

Provider ID
1619405974
Provider Type
Individual
Full Name
Lee-Khalif, Nicole L
Title
Mrs.
Credential
LCSW-C

Gender
Female
Sole Proprietor
Yes
Enumeration Date
5/31/2017
Last Updated
7/21/2022

Contact Information

Practice Location

958 Joshua Tree Ct, Owings Mills, MD 21117-1756

(315) 254-7801

Unlisted Fax

Mailing Location

958 Joshua Tree Ct, Owings Mills, MD 21117-1756

(315) 254-7801

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 17550 Maryland

Nicole L Lee-Khalif

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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