Individual
MRS. JOANNA RUTH DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW C
Contact information
Practice address
3691 PARK AVE, SUITE 2, ELLICOTT CITY, MD 21043-4783
(410) 456-7022
Mailing address
3691 PARK AVE, ELLICOTT CITY, MD 21043-4783
(410) 456-7022
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
09934
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0022
BSDC
—
01
—
100033364
APS
—
01
—
150N
MBMD
—
01
—
150N133G
MBMD
—
01
—
2131895
MAMS
—
01
—
223634
COMP
—
01
—
226106
KAIS
—
01
—
252450
COMP
—
01
—
266715000
MAGE
—
01
—
331945
MHN
—
01
—
360218
MHN
—
01
—
593795443
MAMS
—
01
—
61766403
BSMD
—
01
—
705BPS
BSMD
—
01
—
790298000
MAGE
—
01
—
K452
BSDC
—
Enumeration date
07/17/2006
Last updated
01/06/2015
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