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Individual

MRS. DEANNA LOUISE PHELPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW-C

Contact information

Practice address
4623 FALLS ROAD, BALTIMORE, MD 21209
(410) 366-1980
(410) 366-8530
Mailing address
3523 BAY DR, MIDDLE RIVER, MD 21220-4402
(410) 335-2266

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
04931
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
179967
COMPSYCH
MD
01
226396
KAISER
MD
01
7186396
AETNA BEHAVIORAL HEALTH
MH
01
890943-01
CAREFIRST BCBS
MD
01
PVPB1348746
APS HEALTHCARE
MD
01
T541-0078
CAREFIRST BCBS
MD
Enumeration date
07/17/2006
Last updated
07/09/2007
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