Provider Demographics
NPI:1114113024
Name:TERRY, MARGARET ELLSWORTH (LCSW-C)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ELLSWORTH
Last Name:TERRY
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 1:7931 EDGEWOOD FARM RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-2909
Mailing Address - Country:US
Mailing Address - Phone:301-695-2720
Mailing Address - Fax:
Practice Address - Street 1:11670 OLD NATIONAL PIKE
Practice Address - Street 2:SUITE 103
Practice Address - City:NEW MARKET
Practice Address - State:MD
Practice Address - Zip Code:21774-6121
Practice Address - Country:US
Practice Address - Phone:301-865-2226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD134771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical