Healthcare Provider Details

I. General information

NPI: 1114256096
Provider Name (Legal Business Name): STACEY J HELLMAN LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: STACEY J HELLMAN LCSW-C

II. Dates (important events)

Enumeration Date: 12/23/2009
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525H ELLICOTT MILLS DR STE 104
ELLICOTT CITY MD
21043-4544
US

IV. Provider business mailing address

3525H ELLICOTT MILLS DR STE 104
ELLICOTT CITY MD
21043-4544
US

V. Phone/Fax

Practice location:
  • Phone: 410-206-8573
  • Fax: 410-203-2301
Mailing address:
  • Phone: 410-206-8573
  • Fax: 410-203-2301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13359
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: