Healthcare Provider Details

I. General information

NPI: 1841473469
Provider Name (Legal Business Name): SHEILA M ERVIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2007
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 W PATRICK ST
FREDERICK MD
21701-4027
US

IV. Provider business mailing address

611 W PATRICK ST
FREDERICK MD
21701-4027
US

V. Phone/Fax

Practice location:
  • Phone: 240-439-4900
  • Fax:
Mailing address:
  • Phone: 240-439-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number25013
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: