Healthcare Provider Details

I. General information

NPI: 1477802650
Provider Name (Legal Business Name): LINDSAY GUNTOW LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2012
Last Update Date: 02/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 SOLAREX COURT SUITE 201
FREDERICK MD
21703-7005
US

IV. Provider business mailing address

6501 N. CHARLES STREET
BALTIMORE MD
21204-6819
US

V. Phone/Fax

Practice location:
  • Phone: 301-663-8263
  • Fax: 301-682-5326
Mailing address:
  • Phone: 410-938-3464
  • Fax: 410-938-3410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14621
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: