Healthcare Provider Details

I. General information

NPI: 1881724516
Provider Name (Legal Business Name): CONSTANCE N. LACAP DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CONSTANCE N. HOUSER DO

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 LINDEN AVE FL 2 CARRUTHERS CLINIC
BALTIMORE MD
21201-4606
US

IV. Provider business mailing address

701 W PRATT ST PSYCHIATRY, 4TH FLOOR
BALTIMORE MD
21201-1023
US

V. Phone/Fax

Practice location:
  • Phone: 410-462-5799
  • Fax: 410-462-5836
Mailing address:
  • Phone: 410-328-6325
  • Fax: 410-328-1212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberH0068718
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: