Healthcare Provider Details

I. General information

NPI: 1811301286
Provider Name (Legal Business Name): JESSICA GIORDANA LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2014
Last Update Date: 07/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 NORTH POINT RD
BALTIMORE MD
21224-3338
US

IV. Provider business mailing address

1012 NORTH POINT RD
BALTIMORE MD
21224-3338
US

V. Phone/Fax

Practice location:
  • Phone: 443-216-4800
  • Fax: 443-216-4801
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number19873
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: