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General NPI Number Information
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NPI Number | 1538304894
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Entity Type | Individual
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Provider Name | ELLEN CRUICE SATYSHUR LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 12/15/2008
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Last Update Date | 11/24/2020
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Provider Practice Location Address
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Address Line | 3300 N CALVERT ST
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City | BALTIMORE
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State | MD
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Zip | 21218-2820
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Country | US
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Telephone | 410-544-6600
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Fax | 410-544-6603
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Provider Business Mailing Address
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Address Line | 3300 N CALVERT ST
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City | BALTIMORE
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State | MD
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Zip | 21218-2820
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Country | US
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Telephone | 410-544-6600
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Fax | 410-544-6603
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW 9160
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 15836
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License Number State | MD
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