Healthcare Provider Details

I. General information

NPI: 1457718066
Provider Name (Legal Business Name): GEOFFREY MICHAEL HUNT LCSW-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2016
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6535 N CHARLES ST SUITE 300
BALTIMORE MD
21204-5826
US

IV. Provider business mailing address

6535 N CHARLES ST SUITE 300
BALTIMORE MD
21204-5826
US

V. Phone/Fax

Practice location:
  • Phone: 410-938-5252
  • Fax: 410-938-5250
Mailing address:
  • Phone: 410-938-5252
  • Fax: 410-938-5250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number19952
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: