Provider Demographics
NPI:1083786032
Name:HERBERS, MARY FOSTER (MSW LCSWC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:FOSTER
Last Name:HERBERS
Suffix:
Gender:F
Credentials:MSW LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15521 VILLISCA TERRACE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20855
Mailing Address - Country:US
Mailing Address - Phone:301-838-9755
Mailing Address - Fax:
Practice Address - Street 1:15521 VILLISCA TERRACE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20855
Practice Address - Country:US
Practice Address - Phone:301-838-9755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD084601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD7452241Medicaid
MDB080OtherBLUE CROSS
MD604408Medicare ID - Type Unspecified