Healthcare Provider Details
I. General information
NPI: 1275341927
Provider Name (Legal Business Name): STRIVING TO OVERCOME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/27/2024
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
205 STEEPLE CHASE DR STE 303
PRINCE FREDERICK MD
20678-4054
US
IV. Provider business mailing address
PO BOX 661
PRINCE FREDERICK MD
20678-0661
US
V. Phone/Fax
- Phone: 443-404-1956
- Fax: 410-414-8002
- Phone: 443-404-1956
- Fax: 410-414-8002
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 071284100 |
| Identifier Type | MEDICAID |
| Identifier State | MD |
| Identifier Issuer | |
VIII. Authorized Official
Name:
SHARMAN
WARRICK
Title or Position: CLINICAL SOCIAL WORKER
Credential: LCSW-C
Phone: 443-404-1956