| Senior Care Therapy Lcsw Of Maryland Llc | |
|
822 Guilford Ave # 1526 Baltimore MD 21202-3707 | |
| (973) 264-0023 | |
| (973) 264-0022 |
| Full Name | Senior Care Therapy Lcsw Of Maryland Llc |
|---|---|
| Speciality | Social Worker |
| Location | 822 Guilford Ave # 1526, Baltimore, Maryland |
| Authorized Official Name and Position | Alisa Rosenfeld (OWNER) |
| Authorized Official Contact | 9732640023 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Senior Care Therapy Lcsw Of Maryland Llc 2719 Hollywood Blvd Ste 5469 Hollywood FL 33020-4821 Ph: (973) 264-0023 | Senior Care Therapy Lcsw Of Maryland Llc 822 Guilford Ave # 1526 Baltimore MD 21202-3707 Ph: (973) 264-0023 |
| NPI Number | 1912500463 |
|---|---|
| Provider Enumeration Date | 11/18/2020 |
| Last Update Date | 01/11/2024 |
| Certification Date | 01/11/2024 |
| Medicare PECOS PAC ID | 5597174797 |
|---|---|
| Medicare Enrollment ID | O20210428003103 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912500463 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Sherley Simon Xavier |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124775325 PECOS PAC ID: 0446633580 Enrollment ID: I20220822003690 |
| Provider Name | Brittany Bascombe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285163766 PECOS PAC ID: 3779991393 Enrollment ID: I20230522002316 |
| Provider Name | Loretta Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649309857 PECOS PAC ID: 5294155230 Enrollment ID: I20230616002492 |
| Provider Name | Torrie Blackwell |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1063986032 PECOS PAC ID: 9032569108 Enrollment ID: I20240102002416 |
| Provider Name | Jaime Duckett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083126973 PECOS PAC ID: 4587007315 Enrollment ID: I20240208003650 |
| Provider Name | Tammy Langley-prout |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598157257 PECOS PAC ID: 0446694350 Enrollment ID: I20240220000672 |
| Provider Name | Lakeiya Cherry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659618353 PECOS PAC ID: 5193189983 Enrollment ID: I20240501000147 |
| Provider Name | Kamilah Woodson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033401781 PECOS PAC ID: 9133385982 Enrollment ID: I20240510000011 |
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