Healthcare Provider Details

I. General information

NPI: 1811327380
Provider Name (Legal Business Name): LORY COSNER MSW, LCSW, LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2013
Last Update Date: 09/22/2023
Certification Date: 06/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 WEST STREET
ANNAPOLIS MD
21401
US

IV. Provider business mailing address

210 LEGION AVE # 6294
ANNAPOLIS MD
21401-4125
US

V. Phone/Fax

Practice location:
  • Phone: 410-429-0285
  • Fax:
Mailing address:
  • Phone: 443-343-2522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.021688
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2019029974
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05571000
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberTPSW1853
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number26959
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: