Provider Demographics
NPI:1013573500
Name:LAFFERTY, JOHN A (LMSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:LAFFERTY
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8704 BLAIRWOOD RD APT B2
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-2396
Mailing Address - Country:US
Mailing Address - Phone:202-683-0049
Mailing Address - Fax:
Practice Address - Street 1:8704 BLAIRWOOD RD APT B2
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-2396
Practice Address - Country:US
Practice Address - Phone:202-683-0049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD201961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical