Individual
MS. LORETTA MARTHA ELIZALDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
130 SLADE AVE STE B, PIKESVILLE, MD 21208-4910
(410) 484-3892
(410) 484-3924
Mailing address
130 SLADE AVE APT 620, BALTIMORE, MD 21208-4942
(410) 241-6006
(410) 484-3924
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LC2240
MD
101YM0800X
Mental Health Counselor
Primary
LC2240
MD
171M00000X
Case Manager/Care Coordinator
LC2240
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LC2240
LCPC
MD
Enumeration date
06/01/2007
Last updated
06/13/2021
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