Provider Demographics
NPI:1093865974
Name:METZLER, JAMIE TODD (LCSW-C)
Entity Type:Individual
Prefix:MR
First Name:JAMIE
Middle Name:TODD
Last Name:METZLER
Suffix:
Gender:M
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 1:1435 BOYLE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-5112
Mailing Address - Country:US
Mailing Address - Phone:443-468-8834
Mailing Address - Fax:
Practice Address - Street 1:5710 NEWBURY ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3657
Practice Address - Country:US
Practice Address - Phone:443-501-4094
Practice Address - Fax:443-501-4094
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD146591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical