Healthcare Provider Details

I. General information

NPI: 1518246099
Provider Name (Legal Business Name): NIKITA PARSON MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2011
Last Update Date: 05/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W PRATT ST
BALTIMORE MD
21201-1023
US

IV. Provider business mailing address

PO BOX 64515
BALTIMORE MD
21264-4515
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-5881
  • Fax: 410-328-8552
Mailing address:
  • Phone: 410-328-5881
  • Fax: 410-328-8552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15695
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: