Healthcare Provider Details

I. General information

NPI: 1053424531
Provider Name (Legal Business Name): STEVEN BRIAN WECHSLER LCSW-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 10/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 WOOD HILL RD
ROCKVILLE MD
20850-8724
US

IV. Provider business mailing address

6269 PIMLICO RD
BALTIMORE MD
21209-3331
US

V. Phone/Fax

Practice location:
  • Phone: 301-838-4200
  • Fax: 301-468-1862
Mailing address:
  • Phone: 410-358-2668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11576
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: