Healthcare Provider Details

I. General information

NPI: 1396669198
Provider Name (Legal Business Name): ANDREA ANNELIA NOEL LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W PENNSYLVANIA AVE
TOWSON MD
21204-4264
US

IV. Provider business mailing address

5505 WINTHROPE AVE
BALTIMORE MD
21214-2768
US

V. Phone/Fax

Practice location:
  • Phone: 443-718-0496
  • Fax:
Mailing address:
  • Phone: 202-538-6504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number34502
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: