Healthcare Provider Details

I. General information

NPI: 1750734687
Provider Name (Legal Business Name): STEPHANIE P CAVALIERE LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2016
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 MONTROSE MANOR CT
CATONSVILLE MD
21228-5015
US

IV. Provider business mailing address

27 MONTROSE MANOR CT APT H
CATONSVILLE MD
21228-5014
US

V. Phone/Fax

Practice location:
  • Phone: 518-545-4466
  • Fax:
Mailing address:
  • Phone: 631-942-6480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number25180
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number092009
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: