Healthcare Provider Details

I. General information

NPI: 1245328848
Provider Name (Legal Business Name): WANDA DENISE CURRIE MSW, LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 11/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 GARFIELD CT 224 N WASHINGTON STREET, STE 4
HAVRE DE GRACE MD
21078-2537
US

IV. Provider business mailing address

101 GARFIELD CT 224 NORTH WASHINGTON STREET, STE 4
HAVRE DE GRACE MD
21078-2537
US

V. Phone/Fax

Practice location:
  • Phone: 410-836-6437
  • Fax: 410-939-6252
Mailing address:
  • Phone: 410-836-6437
  • Fax: 410-939-6252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number09961
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: