Healthcare Provider Details

I. General information

NPI: 1295306652
Provider Name (Legal Business Name): ABI STEFANELLI LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2021
Last Update Date: 07/07/2021
Certification Date: 07/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5820 YORK RD STE 201
BALTIMORE MD
21212-3620
US

IV. Provider business mailing address

780 WASHINGTON BLVD APT 2F
BALTIMORE MD
21230-2303
US

V. Phone/Fax

Practice location:
  • Phone: 410-800-2169
  • Fax: 410-777-8742
Mailing address:
  • Phone: 240-671-8320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number27473
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: