Healthcare Provider Details

I. General information

NPI: 1467901827
Provider Name (Legal Business Name): MICHAEL LOUIS APPLEBAUM LCSW-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2016
Last Update Date: 09/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9309 BELAIR RD SUITE A
NOTTINGHAM MD
21236-1605
US

IV. Provider business mailing address

1 BELLINGTON CT
NOTTINGHAM MD
21236-1333
US

V. Phone/Fax

Practice location:
  • Phone: 410-529-1309
  • Fax:
Mailing address:
  • Phone: 443-695-0222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number19131
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: