Healthcare Provider Details

I. General information

NPI: 1700289535
Provider Name (Legal Business Name): REBECCA A. HELEM MSW, LICSW, LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2014
Last Update Date: 01/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3120 ERDMAN AVE
BALTIMORE MD
21213
US

IV. Provider business mailing address

3501 SINCLAIR LN
BALTIMORE MD
21213-2029
US

V. Phone/Fax

Practice location:
  • Phone: 410-558-4800
  • Fax: 410-675-8947
Mailing address:
  • Phone: 410-732-8800
  • Fax: 443-703-3242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC50078363
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17701
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: