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Individual

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Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW-C

Contact information

Practice address
10711 RED RUN BLVD STE 101, OWINGS MILLS, MD 21117-5138
(443) 744-9463
Mailing address
9616 EAVES DR, OWINGS MILLS, MD 21117-5918
(443) 744-9463

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17880
MD

Other

Enumeration date
01/09/2013
Last updated
08/11/2025
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