Healthcare Provider Details

I. General information

NPI: 1881488930
Provider Name (Legal Business Name): ELIE SAUL HOLZEL MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 N BROADWAY
BALTIMORE MD
21205-1832
US

IV. Provider business mailing address

4 HOMESTEAD DR APT H
OWINGS MILLS MD
21117-5207
US

V. Phone/Fax

Practice location:
  • Phone: 443-923-1870
  • Fax:
Mailing address:
  • Phone: 301-520-5480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33139
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: