Provider Demographics
NPI:1073666319
Name:BALTIMORE-SWAN, ROCHELLE EILEEN (LCSWC)
Entity Type:Individual
Prefix:MS
First Name:ROCHELLE
Middle Name:EILEEN
Last Name:BALTIMORE-SWAN
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 DALI CT
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25403-7680
Mailing Address - Country:US
Mailing Address - Phone:304-260-9301
Mailing Address - Fax:
Practice Address - Street 1:34 WALNUT STREET
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740
Practice Address - Country:US
Practice Address - Phone:301-393-3456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD125451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD211841OtherMEDICARE PROVIDER NUMBER