Healthcare Provider Details

I. General information

NPI: 1356070304
Provider Name (Legal Business Name): NICHOLAS HARMER LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2022
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 N POINT BLVD
BALTIMORE MD
21224-3417
US

IV. Provider business mailing address

509 TRIMBLE RD
JOPPA MD
21085-4003
US

V. Phone/Fax

Practice location:
  • Phone: 443-231-3040
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number28656
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: