Provider Demographics
NPI:1093943672
Name:GIORDANO, MARY ANN E (PHD, LCPC)
Entity Type:Individual
Prefix:DR
First Name:MARY ANN
Middle Name:E
Last Name:GIORDANO
Suffix:
Gender:F
Credentials:PHD, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P. O. BOX 146
Mailing Address - Street 2:CREATIVE COMPANIONING
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21094-0146
Mailing Address - Country:US
Mailing Address - Phone:410-560-6885
Mailing Address - Fax:410-560-6885
Practice Address - Street 1:9 SCHILLING ROAD
Practice Address - Street 2:HUNT VALLEY COUNSELING CENTER
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21031
Practice Address - Country:US
Practice Address - Phone:410-527-0280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1954101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD406755000Medicaid
MD406755002Medicaid