Provider Demographics
NPI:1073884995
Name:HANCOCK, MARCIA JEAN (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:JEAN
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14440 CHERRY LANE CT
Mailing Address - Street 2:208
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4946
Mailing Address - Country:US
Mailing Address - Phone:301-509-4720
Mailing Address - Fax:
Practice Address - Street 1:14440 CHERRY LANE CT
Practice Address - Street 2:208
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4946
Practice Address - Country:US
Practice Address - Phone:301-509-4720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD151691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical