Healthcare Provider Details

I. General information

NPI: 1063326957
Provider Name (Legal Business Name): SIVALESHWARI RAMU LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14204 COLEFORD CT
LAUREL MD
20707-9444
US

IV. Provider business mailing address

14204 COLEFORD CT
LAUREL MD
20707-9444
US

V. Phone/Fax

Practice location:
  • Phone: 301-758-0907
  • Fax:
Mailing address:
  • Phone: 301-758-0907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number35567
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: