Individual ProviderTina Jordan RutherfordSocial WorkerBehavioral Health & Social Service ProvidersPractice Address1451 Rockville Pike, Rockville, MD 20852-1486(240) 472-7733PECOS EnrollmentBased on the most recent information from CMS, provider Tina Jordan Rutherford does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1194087221Provider TypeIndividualFull NameRutherford, Tina JordanCredentialLICSWGenderFemaleSole ProprietorNoEnumeration Date6/14/2012Last Updated4/28/2023Contact InformationPractice LocationPractice Address1451 Rockville Pike, Rockville, MD 20852-1486Phone(240) 472-7733FaxUnlisted FaxMailing LocationMailing Address1451 Rockville Pike, Ste 250 Pmb211, Rockville, MD 20852-1451Phone(240) 472-7733FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseLC50079316District of Columbia