Healthcare Provider Details

I. General information

NPI: 1780270447
Provider Name (Legal Business Name): CHARLENE DENISE BATTS THOMAS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2020
Last Update Date: 12/17/2020
Certification Date: 12/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 N CALVERT ST STE 555
BALTIMORE MD
21218-6518
US

IV. Provider business mailing address

4106 SIHLER OAKS TRL
OWINGS MILLS MD
21117-5003
US

V. Phone/Fax

Practice location:
  • Phone: 716-725-1805
  • Fax: 855-655-5326
Mailing address:
  • Phone: 443-414-4817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: